Increased meteorological sensitivity and disruption of adaptation processes, which are typical for patients with chronic coronary heart disease (CHD), determine the environment as a factor that can actively influence on the disease course. The wide spread of CHD, often accompanied by the development of paroxysmal atrial fibrillation, caused the relevance of the study of meteorological effects among these patients. It's performed the evaluation of geomagnetic and meteorological conditions accompanied by the increasing frequency of atrial fibrillation paroxysms in patients with CHD. There were analysed heart rate variability among patients whit CHD and paroxysmal atrial fibrillation under different meteorological and heliophysical conditions and demonstrated the heterogeneity of changes in the vagosympathetic balance in favourable and unfavourable weather types.