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- Title
Acute Consumption of Alcohol and Discrete Atrial Fibrillation Events.
- Authors
Marcus, Gregory M.; Vittinghoff, Eric; Whitman, Isaac R.; Joyce, Sean; Yang, Vivian; Nah, Gregory; Gerstenfeld, Edward P.; Moss, Joshua D.; Lee, Randall J.; Lee, Byron K.; Tseng, Zian H.; Vedantham, Vasanth; Olgin, Jeffrey E.; Scheinman, Melvin M.; Hsia, Henry; Gladstone, Rachel; Fan, Shannon; Lee, Emily; Fang, Christina; Ogomori, Kelsey
- Abstract
<bold>Background: </bold>Patients' self-reports suggest that acute alcohol consumption may trigger a discrete atrial fibrillation (AF) event.<bold>Objective: </bold>To objectively ascertain whether alcohol consumption heightens risk for an AF episode.<bold>Design: </bold>A prospective, case-crossover analysis.<bold>Setting: </bold>Ambulatory persons in their natural environments.<bold>Participants: </bold>Consenting patients with paroxysmal AF.<bold>Measurements: </bold>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.<bold>Results: </bold>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.<bold>Limitation: </bold>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.<bold>Conclusion: </bold>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.<bold>Primary Funding Source: </bold>National Institute on Alcohol Abuse and Alcoholism.
- Subjects
NATIONAL Institute on Alcohol Abuse &; Alcoholism (U.S.); ATRIAL fibrillation; ALCOHOL drinking; ALCOHOLISM; BLOOD alcohol; ATRIAL flutter; ARRHYTHMIA; AMBULATORY electrocardiography; RESEARCH funding; CROSSOVER trials; LONGITUDINAL method
- Publication
Annals of Internal Medicine, 2021, Vol 174, Issue 11, p1503
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/M21-0228