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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...

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

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

DESIGN
A prospective, case-crossover analysis.

SETTING
Ambulatory persons in their natural environments.

PARTICIPANTS
Consenting patients with paroxysmal AF.

MEASUREMENTS
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.

RESULTS
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.

LIMITATION
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.

CONCLUSION
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.

PRIMARY FUNDING SOURCE
National Institute on Alcohol Abuse and Alcoholism.


Item Type
Article
Publication Type
International, Open Access, Article
Drug Type
Alcohol
Intervention Type
Prevention, Harm reduction
Date
31 August 2021
Identification #
https://doi.org/10.7326/m21-0228
Publisher
American College of Physicians
Volume
Early online
EndNote

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