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The association between seasonality and the incidence of permanent pacemaker implantations due to atrioventricular

Reut Doga1, Shaked Yarza1,2, Aharona Glatman-Freedman3,4

  • 1Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.

International Journal of Environmental Health Research
|August 1, 2025
PubMed

Insights

Cold weather increases the need for permanent pacemaker implantation (PPM) due to atrioventricular (AV) block. A study found that lower temperatures correlated with higher PPM implantation rates, particularly in winter.

Area of Science:

  • Cardiology
  • Environmental Health
  • Medical Statistics

Background:

  • Winter is linked to increased cardiovascular issues.
  • Limited data exists on seasonal variations in permanent pacemaker implantation (PPM) for advanced atrioventricular (AV) block.

Purpose of the Study:

  • To investigate the association between seasonal variations, meteorological factors, influenza rates, and the incidence of PPM implantation due to AV block.

Main Methods:

  • Retrospective analysis of 759 patients requiring PPM for AV block.
  • Assessment of daily PPM implantation incidence against season, temperature, humidity, rainfall, and influenza rates.
  • Statistical analysis including adjusted regression models.

Main Results:

  • A 5-degree Celsius decrease in ambient temperature was significantly associated with a higher daily incidence of PPM implantation (adjusted RR: 1.06).
  • PPM implantation rates were higher in winter compared to fall, especially in men, though not statistically significant (adjusted RR: 1.31).
  • No significant association was found between PPM implantation and influenza season.

Conclusions:

  • Declining ambient temperatures may be linked to an increased need for PPM implantation due to AV block.
  • Further research is needed to confirm the relationship between temperature decline and AV block, and to identify potential confounding variables.

Keywords:
AV blockPacemakerinfluenzaseason

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