Alcohol-related acute atrial fibrillation. A case-control study and review of 40 patients.

Heavy alcohol use has been suspected to cause acute atrial fibrillation, but an association between these two common problems has never been demonstrated. We retrospectively reviewed 64 cases with idiopathic acute atrial fibrillation and 64 age- and sex-matched controls, randomly selected from among general medical admissions. Sixty-two percent of cases and 33% of controls had documentation as heavy users of alcohol. Furthermore, patients with alcohol-related atrial fibrillation were significantly more likely to manifest alcohol withdrawal syndrome than were other inpatients with heavy alcohol use. Patients with alcohol-related acute atrial fibrillation were not different from other patients with acute atrial fibrillation with respect to clinical evidence of congestive heart failure, electrocardiographic abnormalities, cardiomegaly, electrolyte disturbance, or response to therapy. Heavy alcohol use is an important potential etiology for acute atrial fibrillation; alcohol withdrawal may represent a particular risk for such alcohol-related atrial fibrillation.