The risk of acute heavy alcohol intake on the
development of atrial fibrillation (AF), aka ‘holiday heart syndrome’, has been
well-described. However, whether chronic
alcohol intake is also associated with increased risk of AF, or might even be
protective as has been observed with other cardiac conditions, is more
uncertain. A number of studies, from
basic science to large cohort studies have been performed to analyze the
association between alcohol and AF. Basic-level studies have found that alcohol causes changes in tissue
electrophysiology, ion channels, and circulating hormones, which might promote
development and maintenance of AF. Clinical studies have generally shown groups with the highest regular
intake of alcohol to be at increased risk, with no association with more
moderate use. However, these studies
have not always accounted for other AF risk factors, been inconsistent in the
assessment and validation of the quantity of alcohol consumed across populations,
and been unable to completely separate drinking patterns from overall health of
participants. As a result, solid
conclusions about a threshold level for ‘safe’ chronic alcohol intake cannot be
made with regard to AF risk, but it appears to be safe within currently
recommended limits of 1 drink daily for women and 2 for men. In this review, we discuss these findings,
limitations, and conclusions.
Credits: Michael A. Rosenberg; MD and Kenneth J. Mukamal, MD, MPH