Alcohol intake is significantly associated with atrial flutter in patients under 60 years of age and a shorter right atrial effective refractory period
Open accessAbstract
BACKGROUND: Although evidence suggests that alcohol is associated with atrial fibrillation (AF), the association between alcohol and atrial flutter (AFL) has not been examined. The mechanism connecting alcohol and atrial arrhythmias is unknown. METHODS: Alcohol intake was determined in 195 consecutive patients with AF and AFL. Control subjects included patients with other supraventricular arrhythmias (n = 132) and healthy subjects (n = 54). Because of important competing risk factors for atrial arrhythmias in the elderly, stratification by age was performed. In a subset, atrial effective refractory periods (AERPs) were obtained from the high right atrium and proximal and distal coronary sinus. RESULTS: AF and AFL patients were significantly more likely to be daily alcohol drinkers (27% vs 14% of controls, P = 0.001). In multivariable analysis, AFL patients < or = 60 years of age were significantly more likely to be daily drinkers than to drink no alcohol compared to controls (odds ratio 17, 95% confidence interval 1.6-192.0, P = 0.019). Progressively more frequent alcohol intake was significantly associated with a progressively greater odds of AFL in patients < or = 60 years of age (P = 0.045). Neither AF subjects of any age nor AFL subjects > 60 years of age exhibited significant associations with alcohol after multivariable adjustment. Right AERPs shortened significantly with increasing amounts of alcohol intake (P = 0.025), whereas left AERPs were not associated with alcohol intake. CONCLUSIONS: Alcohol intake is positively associated with AFL in younger patients. The mechanism may be related to a shortening of the right AERP.
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AFL is seen in clinical conditions very much alike those seen in AF, including old age, hypertension, diabetes, chronic obstructive lung disease, excessive alcohol consumption, and high intensity sports practice.
“AFL is seen in clinical conditions very much alike those seen in AF, including old age, hypertension, diabetes, chronic obstructive lung disease, excessive alcohol consumption 172 and high intensity sports practice.173”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [172]
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- Authors
- MARCUS, G. M., SMITH, L. M., WHITEMAN, D., TSENG, Z. H., BADHWAR, N., LEE, B. K., LEE, R. J., SCHEINMAN, M. M., & OLGIN, J. E.
- Affiliations
- University of California, San Francisco (US)
- Corresponding author
- MARCUS, GREGORY M.
- ORCID
- Venue
- Pacing and Clinical Electrophysiology
- Publisher
- Wiley
- Published
- 2008-02-28
- Volume
- 31
- Issue
- 3
- Pages
- 266-272
- ISSN
- 0147-8389 (ISSN-L)
- 1540-8159
- OpenAlex
- W2008077084
- Cited by
- 75
- References
- 24
- Citations by year
- 2025: 5 · 2024: 5 · 2023: 2 · 2022: 6 · 2021: 3 · 2020: 6 · 2019: 5 · 2018: 1 · 2017: 5 · 2016: 5 · 2015: 3 · 2014: 7 · 2013: 5 · 2012: 5
- FWCI
- 2.91
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Pacing and Clinical Electrophysiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Center for Research Resources (K12 RR024130)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- alcohol consumption, atrial flutter, atrial fibrillation, atrial effective refractory period, right atrium, young adults, supraventricular arrhythmias
- MeSH terms
- Adolescent, Adult, Alcohol Drinking, Atrial Flutter, California, Electrocardiography, Female, Heart Conduction System, Humans, Male, Middle Aged, Risk Factors, Statistics as Topic, Comorbidity, Prevalence, Case-Control Studies, Age Distribution, Risk Assessment
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