SAN FRANCISCO, CALIFORNIA. It is well established that binge drinking and long-term alcohol abuse are risk factors for atrial fibrillation. Now researchers at the University of California report that alcohol consumption is also a significant risk factor for right atrial flutter (AFL), at least in persons at or below the age of sixty years. Their study involved 195 patients (121 with atrial fibrillation and 74 with AFL) who presented for cardioversion or ablation over a two-year period. A control group consisting of 132 patients with SVT (supraventricular tachycardia) and 54 with no known arrhythmia were also included. About 13% of participants had coronary artery disease or congestive heart failure, and 28% had hypertension.

The researchers found a strong correlation between daily alcohol consumption and the prevalence of AFL in those at or below the age of 60 years. After correcting for potential confounders (gender, race, hypertension, congestive heart failure, coronary artery disease, and body mass index) the researchers conclude that daily alcohol consumption (1-2 drinks per day) is associated with an 11 times greater prevalence of AFL. No such relationship was found among patients older than 60 years nor among those with atrial fibrillation.

The California researchers also observed a strong correlation between daily alcohol intake and a shorter atrial effective refractory period (AERP) in the right atrium and speculate that a shorter AERP may facilitate the initiation of AFL by allowing propagation of a critically-timed premature atrial complex (PAC).

Marcus, GM, et al. Alcohol intake is significantly associated with atrial flutter in patients under 60 years of age and a shorter right atrial effective refractory period. PACE, Vol. 31, March 2008, pp. 266-72