Cold weather may raise the risk of heart problems, say researchers.

Cold weather has a bad effect on health apart from flu and other infections. The cold air affects our circulation and metabolic activities, the heart has to pump more blood to maintain body temperature.

Doctors often report heart beating arrhythmically, one minute too fast, the next too slowly. Short-term, it was unlikely to be dangerous, but about half of patients with atrial flutter may develop full-fledged AFib. Long-term, it threatened to trigger a stroke or a heart attack.

“Make no mistake: AFib has serious consequences,” says Mohit K. Turagam, an electrophysiologist and associate professor at the Icahn School of Medicine at Mount Sinai Hospital and author of more than 175 peer-reviewed scientific papers about cardiac arrhythmias. “But it’s highly preventable and highly treatable. No one has to suffer with it on a day-to-day basis. Patients who get therapy can do really well.”

AFib is an irregular heart rhythm or arrhythmia. The heart’s upper chambers, called the atria, beat chaotically, out of sync with the ventricles, the lower chambers. Too little blood is pumped, too slowly, and electrical impulses that normally cycle through your heart may be interrupted.

The Cleveland Clinic website likens the phenomenon-poetically so-to an orchestra led by two conductors, leaving musicians conflicted about which to follow and which harmonies and rhythms to play.

Rapid heartbeat, shortness of breath, dizziness or lightheadedness, chest pain and fatigue are all typical AFib symptoms. They may crop up for a few minutes or hours, be intermittent or persistent, and last weeks, months or longer. But an estimated 10 to 40 percent of people with AFib have no symptoms.

A 2015 meta-analysis of 15 studies, involving more than 125,000 patients and published in the Journal of Atrial Fibrillation, found that paroxysmal-or intermittent-AFib occurs most often in winter and least often in summer, dropping lowest in July.

Stroke risk in AFib patients ran 19 percent higher in winter than in summer and 10 percent higher than in spring, found a study of almost 290,000 patients presented at the European Society of Cardiology. Overall, the condition sharply ups the chances of suffering a stroke, heart failure and even dementia. If AFib is left untreated, the probability of stroke increases fivefold, the American Heart Association (AHA) reports, and the probability of death from heart failure doubles.

Not all researchers agree, though. A 2022 study in the Journal of the American Heart Association, reported that hospital admissions for AFib varied little seasonally.

Other research suggests a trend toward atrial flutter being diagnosed at younger ages than ever before. The National Heart, Lung and Blood Institute (NHLBI) is studying whether wearable devices such as smartwatches might help detect, diagnose and better manage AFib than current approaches.

About 1 in 3 people 55 or older face a lifetime risk of developing AFib, but for those who age without a single chronic illness or co-morbidity, only 1 in 5 run the same risk, and the condition is most widespread among those 65-plus. The Centers for Disease Control and Prevention estimates that there are over 450,000 hospitalizations involving AFib every year, and that 12.1 million people in the United States will have AFib in 2030. AFib alone is rarely fatal, but it is a factor in many deaths of people with other health conditions.

The main risk factors for AFib are uncontrolled high blood pressure, coronary artery disease, sleep apnea, overweight and obesity, a family history of the disorder and alcohol intake (the more you drink, the higher the risks-a problem serious enough come late December to be termed “holiday heart syndrome”)

The AHA recommends a heart-healthy diet, 150 minutes of aerobic exercise a week, limited alcohol consumption and quitting smoking to avoid AFib and other heart problems.

“Eating right, exercising regularly and losing weight can all be incredibly powerful in mitigating risks and symptoms,” says Jonathan Piccini, a professor of medicine at Duke University Medical Center and the Duke Clinical Research Institute and author of more than 550 peer-reviewed research papers on atrial fibrillation.

Treatments range from medications to control heart rate and rhythm, such as beta blockers to slow your heart rate and blood thinners to stave off stroke, to minimally invasive procedures that block faulty heart signals and therapies that shock the heart back to a regular rhythm.

Electrical cardioversion, for example, administers mild shocks to electrically reset your heart rhythm. Another option, catheter ablation, inserts tubes in the groin that are threaded through blood vessels leading up to the heart’s upper chambers, then deliver energy to kill cells and jolt your electrical signals back to a normal rhythm.

Another treatment called pulsed field ablation, already approved in Europe as an alternative to traditional ablation, is awaiting Food and Drug Administration approval, which could happen in 2024. This past July, a study in the journal Circulation-Turagam was the lead author-showed the new technique to be clinically effective in 78 percent of AFib patients.

An important caveat: AFib can appear to be under control, only to come back sooner or later.

“It can recur, and a patient could have an AFib episode years after the last episode,” says Paul Wang, the director of the Cardiac Arrhythmia Service and professor of medicine at Stanford University, as well as editor of three AHA journals. “And the AFib could be without symptoms or have symptoms only briefly.”

“The big issue is that as conditions associated with AFib increase-and as our elderly population grows larger-AFib will be more prevalent,” says Yves Rosenberg, who oversees clinical trials about cardiovascular disease as chief of the Atherothrombosis and Coronary Artery Disease Branch of NHLBI. “So our public health message about AFib is all about prevention: The better we can prevent these risk factors, the more likely we can prevent AFib.”

Reference: American Heart Association, Press release 2023.