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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.

中文翻译：

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急性饮酒和离散心房颤动事件

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背景：

患者的自我报告表明，急性饮酒可能会引发离散的心房颤动 (AF) 事件。

客观的：

客观地确定饮酒是否会增加房颤发作的风险。

设计：

前瞻性案例交叉分析。

环境：

在自然环境中流动的人。

参加者：

阵发性房颤患者同意。

测量：

参与者佩戴连续心电图 (ECG) 监测仪和脚踝佩戴的透皮乙醇传感器 4 周。使用心电图记录设备上的按钮自行记录所消耗的每种酒精饮料的实时记录。使用指尖采血检测磷脂酰乙醇（PEth）来证实饮酒事件的确定。

结果：

在 100 名参与者中（平均年龄 64 岁 [SD，15]；79% 男性；85% 白人），56 人至少有 1 次 AF 发作。PEth 测试的结果与实时记录的饮酒次数以及透皮酒精传感器检测到的事件相关。AF 发作与 1 次饮酒的几率增加 2 倍相关（优势比 [OR]，2.02 [95% CI，1.38 至 3.17]），与至少 2 次饮酒的几率增加 3 倍以上（OR，3.58） [CI，1.63 至 7.89]) 在之前 4 小时内。AF 发作还与血液酒精浓度峰值（血液酒精浓度每增加 0.1%，OR，1.38 [CI，1.04 至 1.83]）和酒精暴露曲线下总面积（OR，1.14 [CI，CI]）的较高几率相关。 ，1.06 至 1.22] 酒精暴露量每增加 4.7%）根据前 12 小时内的透皮乙醇传感器推断。

局限性：

不能排除可能伴随饮酒的其他随时间变化的暴露的混杂因素，并且当前对饮酒的房颤患者的研究结果可能不适用于一般人群。

结论：

个别房颤发作与近期饮酒的几率较高有关，这提供了客观证据，表明可改变的行为可能会影响离散房颤事件发生的概率。

主要资金来源：

国家酒精滥用和酒精中毒研究所。