Acute Consumption of Alcohol and Discrete Atrial Fibrillation Events.


Journal

Annals of internal medicine
ISSN: 1539-3704
Titre abrégé: Ann Intern Med
Pays: United States
ID NLM: 0372351

Informations de publication

Date de publication:
11 2021
Historique:
pubmed: 31 8 2021
medline: 15 12 2021
entrez: 30 8 2021
Statut: ppublish

Résumé

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.

Sections du résumé

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.

Identifiants

pubmed: 34461028
doi: 10.7326/M21-0228
doi:

Substances chimiques

Blood Alcohol Content 0

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

1503-1509

Subventions

Organisme : NIAAA NIH HHS
ID : K24 AA022586
Pays : United States
Organisme : NIAAA NIH HHS
ID : R01 AA022222
Pays : United States

Commentaires et corrections

Type : CommentIn

Auteurs

Gregory M Marcus (GM)

University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.).

Eric Vittinghoff (E)

University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.).

Isaac R Whitman (IR)

Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania (I.R.W.).

Sean Joyce (S)

University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.).

Vivian Yang (V)

University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.).

Gregory Nah (G)

University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.).

Edward P Gerstenfeld (EP)

University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.).

Joshua D Moss (JD)

University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.).

Randall J Lee (RJ)

University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.).

Byron K Lee (BK)

University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.).

Zian H Tseng (ZH)

University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.).

Vasanth Vedantham (V)

University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.).

Jeffrey E Olgin (JE)

University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.).

Melvin M Scheinman (MM)

University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.).

Henry Hsia (H)

University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.).

Rachel Gladstone (R)

University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.).

Shannon Fan (S)

University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.).

Emily Lee (E)

University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.).

Christina Fang (C)

University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.).

Kelsey Ogomori (K)

University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.).

Robin Fatch (R)

University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.).

Judith A Hahn (JA)

University of California, San Francisco, San Francisco, California (G.M.M., E.V., S.J., V.Y., G.N., E.P.G., J.D.M., R.J.L., B.K.L., Z.H.T., V.V., J.E.O., M.M.S., H.H., R.G., S.F., E.L., C.F., K.O., R.F., J.A.H.).

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