Alcohol consumption and risk of atrial fibrillation in asymptomatic healthy adults.

BACKGROUND: Excessive alcohol consumption is known to be related to atrial fibrillation (AF) development in general population.

OBJECTIVES: To investigate the effect of alcohol consumption on new-onset AF development in asymptomatic healthy individuals.

METHODS: Asymptomatic healthy adults (age <75 years and body mass index <30 kg/m) undergoing routine health examinations from 2007 to 2015 were screened. Those with sinus rhythm and without any previously diagnosed medical or surgical illnesses were recruited for analysis. The primary outcome was new-onset AF, and secondary outcomes were composite of non-AF cardiac events, including clinically significant tachy- or bradyarrhythmias, acute myocardial infarction, heart failure, or cardiac death.

RESULTS: Among 19,634 individuals (50 % male, age 19-74), 199 cardiac events were recorded, including new-onset AF (n=160), acute myocardial infarction (n = 30), clinically significant tachy- or bradyarrhythmia (n=19), during a mean follow-up duration of 7.0 ± 2.8 years. The incidence of new-onset AF was higher in drinkers (HR=2.21, 95% CI 1.55-3.14, p<0.001), whereas composite non-AF cardiac events were not correlated to alcohol. There was a dose-dependent increase in the risk of AF presented according to the amount of alcohol, while the risk increased more abruptly in men than in women. The risk for AF was highest in frequent binge drinkers (HR=3.15, 95% CI 1.98-4.99, p<0.001), compared to infrequent light drinkers.

CONCLUSION: In the asymptomatic healthy population, drinking increases the risk for new-onset AF in a dose-dependent manner, regardless of sex. Frequent, binge drinking should be avoided.