Alcohol Consumption Can Quickly Increase Risk of Atrial Fibrillation in Certain Patients

Alcohol—in quantities as small as a single glass of wine—can quickly and significantly raise an individual’s risk for atrial fibrillation (AF), according to a study published in Annals of Internal Medicine. The investigators said these findings run counter to existing theories that alcohol can be cardioprotective, and instead suggest that reducing or avoiding alcohol might help to mitigate adverse effects.

“Contrary to a common belief that atrial fibrillation is associated with heavy alcohol consumption, it appears that even 1 alcohol drink may be enough to increase the risk,” said Gregory Marcus, MD, MAS, professor of medicine in the Division of Cardiology at the University of California San Francisco (UCSF), in a press release. “Our results show that the occurrence of atrial fibrillation might be neither random nor unpredictable. Instead, there may be identifiable and modifiable ways of preventing an acute heart arrhythmia episode.”

AF is the most common heart arrhythmia observed clinically. However, until now, research has largely focused on therapies for treating the disease or risk factors for developing it, as opposed to factors that determine when and where an episode might occur, according to the investigators. AF can result in decreased quality of life, significant health care costs, stroke, and death.

The study authors analyzed data from 100 patients with documented AF who consumed at least 1 alcoholic drink a month. Participants were recruited from the general cardiology and cardiac electrophysiology outpatient clinics at UCSF. Individuals with a history of alcohol or substance use disorder, those with certain allergies, and those who were changing treatment for their heart condition were excluded from the study.

In order to conduct the study, participants wore an electrocardiogram (ECG) monitor for approximately 4 weeks and pressed a button whenever they had a standard alcoholic drink. Each individual was also fitted with a continuously recording alcohol sensor, and blood tests that reflected alcohol consumption over the previous weeks were administered periodically. Participants consumed a median of 1 drink per day throughout the study period.

The investigators found that 1 alcoholic drink resulted in a 2-fold increase in risk of an AF episode, with 2 or more drinks within the preceding 4 hours leading to a 3-fold increase in risk. AF episodes were also associated with an increased blood alcohol concentration.

“The effects seem to be fairly linear: the more alcohol consumed, the higher the risk of an acute AF event,” Marcus said in the release. “These observations mirror what has been reported by patients for decades, but this is the first objective, measurable evidence that a modifiable exposure may acutely influence the chance that an AF episode will occur.”

The authors note that the study was limited to patients with established AF and did not include the general population. Further, there is a potential limitation of participants possibly forgetting to press their monitor buttons or minimizing the number of button presses due to embarrassment. This would not influence alcohol sensor readings, however, minimizing the cause for concern.

REFERENCE

Alcohol can cause immediate risk of atrial fibrillation [news release]. EurekAlert; August 30, 2021. Accessed August 31, 2021. https://www.eurekalert.org/news-releases/926795