Home > Acute consumption of alcohol and discrete atrial fibrillation events.

Marcus, Gregory M and Vittinghoff, Eric and Whitman, Isaac R and Joyce, Sean and Yang, Vivian and Nah, Gregory and Gerstenfeld, Edward P and Moss, Joshua D and Lee, Randall J and Lee, Byron K and Tseng, Zian H and Vedantham, Vasanth and Olgin, Jeffrey E and Scheinman, Melvin M and Hsia, Henry and Gladstone, Rachel and Fan, Shannon and Lee, Emily and Fang, Christina and Ogomori, Kelsey and Fatch, Robin and Hahn, Judith A (2021) Acute consumption of alcohol and discrete atrial fibrillation events. Annals of Internal Medicine, Early online, https://doi.org/10.7326/m21-0228.

External website: https://www.acpjournals.org/doi/10.7326/M21-0228?u...

Patients' self-reports suggest that acute alcohol consumption may trigger a discrete atrial fibrillation (AF) event.

To objectively ascertain whether alcohol consumption heightens risk for an AF episode.

A prospective, case-crossover analysis.

Ambulatory persons in their natural environments.

Consenting patients with paroxysmal AF.

Participants were fitted with a continuous electrocardiogram (ECG) monitor and an ankle-worn transdermal ethanol sensor for 4 weeks. Real-time documentation of each alcoholic drink consumed was self-recorded using a button on the ECG recording device. Fingerstick blood tests for phosphatidylethanol (PEth) were used to corroborate ascertainments of drinking events.

Of 100 participants (mean age, 64 years [SD, 15]; 79% male; 85% White), 56 had at least 1 episode of AF. Results of PEth testing correlated with the number of real-time recorded drinks and with events detected by the transdermal alcohol sensor. An AF episode was associated with 2-fold higher odds of 1 alcoholic drink (odds ratio [OR], 2.02 [95% CI, 1.38 to 3.17]) and greater than 3-fold higher odds of at least 2 drinks (OR, 3.58 [CI, 1.63 to 7.89]) in the preceding 4 hours. Episodes of AF were also associated with higher odds of peak blood alcohol concentration (OR, 1.38 [CI, 1.04 to 1.83] per 0.1% increase in blood alcohol concentration) and the total area under the curve of alcohol exposure (OR, 1.14 [CI, 1.06 to 1.22] per 4.7% increase in alcohol exposure) inferred from the transdermal ethanol sensor in the preceding 12 hours.

Confounding by other time-varying exposures that may accompany alcohol consumption cannot be excluded, and the findings from the current study of patients with AF consuming alcohol may not apply to the general population.

Individual AF episodes were associated with higher odds of recent alcohol consumption, providing objective evidence that a modifiable behavior may influence the probability that a discrete AF event will occur.

National Institute on Alcohol Abuse and Alcoholism.

Item Type
Publication Type
International, Open Access, Article
Drug Type
Intervention Type
Prevention, Harm reduction
31 August 2021
Identification #
American College of Physicians
Early online

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