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.).
Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania (I.R.W.).
Ann Intern Med. 2021 Nov;174(11):1503-1509. doi: 10.7326/M21-0228. Epub 2021 Aug 31.
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.
患者自述表明，急性饮酒可能引发阵发性心房颤动（房颤）。
客观确定饮酒是否会增加房颤发作的风险。
前瞻性病例交叉分析。
在自然环境中活动的门诊患者。
同意参加的阵发性房颤患者。
参与者佩戴连续心电图（ECG）监测仪和踝部经皮乙醇传感器 4 周。通过 ECG 记录设备上的按钮实时记录每次饮酒量。使用指尖血磷脂酰乙醇（PEth）检测来证实饮酒事件的确定。
在 100 名参与者中（平均年龄 64 岁[标准差 15]；79%为男性；85%为白人），56 人至少发生过 1 次房颤。PEth 检测结果与实时记录的饮酒次数和经皮酒精传感器检测到的事件相关。房颤发作与 1 杯酒的几率增加 2 倍相关（比值比[OR]，2.02[95%CI，1.38 至 3.17]），与前 4 小时内至少饮用 2 杯酒的几率增加 3 倍以上相关（OR，3.58[CI，1.63 至 7.89]）。房颤发作还与更高的峰值血液酒精浓度（OR，每增加 0.1%血液酒精浓度增加 1.38[CI，1.04 至 1.83]）和经皮乙醇传感器推断出的前 12 小时内酒精暴露的总曲线下面积（OR，每增加 4.7%的酒精暴露增加 1.14[CI，1.06 至 1.22]）的几率相关。
不能排除其他可能伴随饮酒的随时间变化的暴露因素的混杂，并且当前关于房颤患者饮酒的研究结果可能不适用于一般人群。
个体房颤发作与近期饮酒的几率增加相关，这提供了可改变行为可能影响离散房颤事件发生概率的客观证据。
美国国家酒精滥用和酒精中毒研究所。
