The Association between Alcohol Consumption and Subclinical Atrial Fibrillation

Abstract

Background: With the increased apply of wearable and cardiac implantable electronic devices, detection of subclinical atrial fibrillation (AF) has risen. Therefore, it became important to identify and manage risk factors for subclinical AF. Although alcohol consumption is a known risk factor, its association with subclinical AF has not been well elucidated.

Objective: The purpose of present research is to investigate whether alcohol consumption contributes to the development of subclinical AF.

Methods: In this prospective study, 433 patients without AF were enrolled in a multicenter pacemaker registry between September 2017 and July 2021. We compared the incidence of subclinical AF (episodes of atrial rate >220 beats per minute without symptoms) between alcohol-drinking and non-alcohol-drinking groups.

Results: During follow-up (median 18 months), incidence and risk of long-duration atrial high-rate episodes (AHRE) {greater than or equal to} 24 hours were increased in the alcohol group compared to that in the non-alcohol group (5.47 vs 2.10 per 100 person-years, adjusted hazard ratio [HR], 2.83; 95% confidence interval [CI], 1.14-7.04; p=0.03). After propensity score matching, incidence and risk of long-duration AHRE were higher in the alcohol group (6.97 vs 1.27 per 100 person-years, adjusted HR, 7.84; 95% CI, 1.21-50.93; p=0.03). The mean burden of long-duration subclinical AF was higher in the alcohol group than in the non-alcohol groups (0.18 vs 1.61% during the follow-up period, p=0.08).

Conclusions: Alcohol consumption was associated with an increased risk of subclinical AF. Long-duration AHRE and the burden of AHRE are higher in alcohol drinkers than in non-alcohol drinkers.

Keywords: pacemaker, subclinical atrial fibrillation, alcohol