Atrial fibrillation (AF) is the most common heart arrhythmia seen clinically. This condition affects about three million people in the United States (U.S.) alone.
Most research on the condition focus on risk factors for developing it and therapies for treatment.
This new study instead looks at alcohol use as a risk factor which determines AF episodes. Reducing AF episodes are important as it decreases its negative effects on patients such as loss of quality of life, significant health care costs, stroke and in the worst case death.
About four decades ago doctors observed the phenomenon of people experiencing arrhythmias after heavy alcohol using episodes. Since then, a number of large observational studies found that regular alcohol use, even one alcoholic beverage a day, are at higher risk of developing AF than people who are alcohol-free.
This new study found that even low-dose alcohol use increases the risk of having an AF episode among AF patients.
Contrary to a common belief that atrial fibrillation is associated with heavy alcohol consumption, it appears that even one alcohol [beverage] may be enough to increase the risk,” said Gregory Marcus, MD, MAS, professor of medicine in the Division of Cardiology at UCSF and lead author of the study, as per UCSF.
Gregory Marcus, MD, MAS, professor of medicine in the Division of Cardiology at UCSF and lead author of the study
The study method was rigorous and eliminated the weaknesses of previous large observation studies. While previous studies mostly relied on self-reported alcohol use this study monitored participants alcohol use in other objective measurements as well to ensure accuracy.
The study was conducted on 100 patients with documented paroxysmal AF (meaning occasional episodes of AF) who consumed at least one alcoholic beverage a month. People with a history of alcohol or substance use disorder were excluded, as were those with certain allergies, or who were changing treatment for their heart condition.
Each study participant wore a an electrocardiogram (ECG) monitor for approximately four weeks. They pressed a button fitted with the ECG whenever they had a standard-size alcoholic beverage. They were also all fitted with a continuously recording alcohol sensor. Researchers did blood tests on alcohol use in previous weeks, periodically.
The researcher found that,
- One alcoholic beverage in the past four hours, increased the risk of an AF episode by two times, and
- Two or more alcoholic beverages in the past four hours, increased the risk of an AF episode by three times.
- AF episodes were also linked with higher blood alcohol concentration.
These findings mean that by reducing or stopping alcohol use AF patients can reduce the number of AF episodes which they face. Thus, AF patients can significantly improve quality of life and reduce risk of stroke and death.
The effects seem to be fairly linear: the more alcohol consumed, the higher the risk of an acute AF event,” said Dr. Marcus, as per UCSF.
Gregory Marcus, MD, MAS, professor of medicine in the Division of Cardiology at UCSF and lead author of the study
Mariann R. Piano, a researcher who has published many studies on alcohol and cardiovascular health said that the findings represent an important step forward in the understanding of how alcohol affects the heart. She called on healthcare providers to have conversation with their patients about alcohol use and on reducing use.
Dr. Piano also called for more research on diverse groups since majority of the participants of the study were white and male.
While this study focused on AF patients there are important take aways for everyone even healthy adults. As Dr. Marcus says, the findings show that alcohol has a near immediate effect on the electrical workings of the heart. This is a negative effect even for healthy adults and could lead to complications later on. Furthermore, alcohol increased the risk of several of the major risk factors of AF such as high blood pressure, heart disease and obesity. Therefore, alcohol use further increases risk of having an AF for healthy adults as well.
Sources:
UCSF: “Alcohol Can Cause Immediate Risk of Atrial Fibrillation“
New York Times: “How Alcohol Affects the Heart“
Fox News: “One alcoholic drink raises risk of irregular heartbeat, study suggests”
