According to new research published in the ‘Nature Cardiovascular Research Journal’, people who consume more alcohol create higher chances of emergency room visits due to atrial fibrillation (AF), an often-deadly heart rhythm disorder.
The study is the first to show a link between higher consumption of alcohol and hospital visits for AF in a large population and the first to associate increased drinking with a higher incidence of new-onset AF in previously undiagnosed individuals.
“Our new data suggest that acute alcohol consumption in the general population is associated with a higher risk of an episode of atrial fibrillation, including a higher risk for a first episode of atrial fibrillation among individuals never previously diagnosed with the condition,” said senior study author Dr. Gregory Marcus, MD, MAS, a professor of medicine at UCSF and associate chief of cardiology for research at UCSF Health.
According to the Centres for Disease Control and Prevention, AF contributes to approximately 158,000 deaths in the US each year. It is a major cause of stroke, as blood clots can form inside fibrillation-prone atria, the upper chambers of the heart. About 12 million people in the US have AF, with steadily increasing numbers of individuals diagnosed over the past two decades.
AF most often arises in individuals with pre-existing heart conditions, but other chronic health conditions, including potentially modifiable behaviors such as obesity and alcohol consumption, also have previously been associated with its development. However, acute triggers of potentially life-threatening AF episodes can be more difficult to study, Dr. Marcus said.
In the new study, Dr. Marcus’ research team first identified days when people are more likely to drink more. The scientists analyzed data without individual identifiers from 36,158 people from all states and 59 countries who used a commercially available, Bluetooth-enabled breathalyzer device, a total of 1,269,054 breath alcohol measurements and looked for days of the year when individuals used their devices significantly more often or had higher breathalyzer measurements.
The researchers determined that the breathalyzer users consumed more alcohol than usual on eight different holidays or days of recurrent national events, New Year’s Day, Martin Luther King, Jr. Day, Super Bowl Sunday, and initiation of daylight-saving time, July 4, Christmas, FIFA World Cup and Father’s Day.
The researchers reviewed records from California’s Office of Statewide Health Planning and Development (OSHPD) of California hospital emergency room visits from January 1, 2005, to December 30, 2015, and identified visits coded for a diagnosis AF. They compared the weeks associated with greater alcohol consumption to all other weeks of the year to see if there were more AF visits on days when people are known to drink more.
The research team found that there was a significantly elevated number of hospital visits for AF when all those empirically identified events were compared to all other days of the year. The results remained significant when comparing all other days of the year versus each of the following events alone: New Year’s Day, initiation of Daylight Savings time, Super Bowl Sunday, and Christmas.
To analyze the incidence of AF hospital-visit rates within subsets of the California population, the researchers broke down the data by age, sex, and race/ethnicity for patients visiting the emergency department with AF, and used 2019 California Census data for measures of total subset population sizes. They found the greatest association between acute alcohol consumption and hospital visits for AF among those over age 65.
In addition, compared to other days, on the recurrent days associated with elevated drinking, the researchers identified an even greater percentage increase in hospital visits for AF among those not previously diagnosed with AF, in comparison to the increase in ER visits on these same days among the previously diagnosed with the condition. According to Dr. Marcus, the study suggested that many new cases of AF are triggered specifically by acute alcohol consumption.
“This may be kind of a wake-up call for those individuals who have an identifiable trigger for their atrial fibrillation, who we might presume would be more highly motivated to avoid alcohol consumption and subsequently to experience a lowering of their atrial fibrillation risk,” Dr. Marcus said.