Atrial fibrillation is an irregular and often rapid heart rate that can increase your risk of stroke, heart failure and other heart-related complications.
During atrial fibrillation, the heart’s two upper chambers (the atria) beat chaotically and irregularly — out of coordination with the two lower chambers (the ventricles) of the heart.
Atrial fibrillation symptoms often include heart palpitations, shortness of breath and weakness.
Episodes of atrial fibrillation can come and go, or you may develop atrial fibrillation that doesn’t go away and may require treatment.
Although atrial fibrillation itself usually isn’t life-threatening, it is a serious medical condition that sometimes requires emergency treatment.
It may lead to complications.
Atrial fibrillation can lead to blood clots forming in the heart that may circulate to other organs and lead to blocked blood flow (ischemia).
Treatments for atrial fibrillation may include medications and other interventions to try to alter the heart’s electrical system.
Some people with atrial fibrillation have no symptoms and are unaware of their condition until it’s discovered during a physical examination. Those who do have atrial fibrillation symptoms may experience signs and symptoms such as:
- Palpitations, which are sensations of a racing, uncomfortable, irregular heartbeat or a flip-flopping in your chest
- Reduced ability to exercise
- Shortness of breath
- Chest pain
Atrial fibrillation may be:
- Occasional. In this case it’s called paroxysmal (par-ok-SIZ-mul) atrial fibrillation. You may have symptoms that come and go, lasting for a few minutes to hours and then stopping on their own.
- Persistent. With this type of atrial fibrillation, your heart rhythm doesn’t go back to normal on its own. If you have persistent atrial fibrillation, you’ll need treatment such as an electrical shock or medications in order to restore your heart rhythm.
- Long-standing persistent. This type of atrial fibrillation is continuous and lasts longer than 12 months.
- Permanent. In this type of atrial fibrillation, the abnormal heart rhythm can’t be restored. You’ll have atrial fibrillation permanently, and you’ll often require medications to control your heart rate.
Alcohol is ubiquitous in Western society, and rates of excessive use among adults remain high.
Excessive alcohol consumption is an established risk factor for atrial fibrillation (AF), but what are the effects of moderate and mild consumption on AF?
In a new study published in HeartRhythm, the official journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, Australian researchers showed that regular moderate alcohol consumption (an average of 14 glasses per week) results in more electrical evidence of scarring and impairments in electrical signaling compared with non-drinkers and light drinkers.
Alcohol consumption is therefore an important modifiable risk factor for AF.
AF is an abnormal heart rhythm characterized by rapid and irregular beating of the atria (the two upper chambers of the heart).
Observational studies suggest that even moderate regular alcohol consumption may increase the risk of AF.
A meta-analysis of seven studies involving nearly 860,000 patients and approximately 12,500 individuals with AF demonstrated an eight percent increase in incident AF for each additional daily standard drink.
Despite the association between regular alcohol intake and AF, however, detailed human electrophysiological studies describing the nature of alcohol-related atrial remodeling have been lacking.
The purpose of this study was to determine the impact of different degrees of alcohol consumption on atrial remodeling using high-density electroanatomic mapping.
In this multi-center cross-sectional study in Australia, investigators performed detailed invasive testing on the atria of 75 patients with AF, 25 in each of three categories: lifelong non-drinkers, mild drinkers, and moderate drinkers.
Patients self-reported their average alcohol consumption in standard drinks per week (one standard glass is around 12 grams of alcohol) over the preceding 12 months.
Patients consuming two to seven drinks per week were considered mild drinkers, while those consuming eight to 21 drinks per week (average 14 drinks per week) were defined as moderate drinkers.
The investigators found that individuals who consumed moderate amounts of alcohol (average 14 drinks per week) had more electrical evidence of scarring and impairments in electrical signaling than non-drinkers and light drinkers.
“This study underscores the importance of excessive alcohol consumption as an important risk factor in AF,” said lead investigator Professor Peter Kistler, MBBS, Ph.D., FHRS, from the Heart Centre, Alfred Hospital, Melbourne, Australia.
“Regular moderate alcohol consumption, but not mild consumption, is an important modifiable risk factor for AF associated with lower atrial voltage and conduction slowing.
These electrical and structural changes may explain the propensity to AF in regular drinkers.
It is an important reminder for clinicians who are caring for patients with AF to ask about alcohol consumption and provide appropriate counselling in those who over-indulge.”
More information: “Moderate alcohol consumption is associated with atrial electrical and structural changes: Insights from high-density left atrial electroanatomic mapping,” HeartRhythm, DOI: 10.1016/j.hrthm.2018.10.041