Alcohol Consumption and Arrhythmias at Munich Octoberfest

May 10, 2017
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Authors:
Brunner S, Herbel R, Drobesch C, et al.
Citation:
Alcohol Consumption, Sinus Tachycardia, and Cardiac Arrhythmias at the Munich Octoberfest: Results From the Munich Beer Related Electrocardiogram Workup Study (MunichBREW). Eur Heart J 2017;Apr 25:[Epub ahead of print].
Summary By:
Debabrata Mukherjee, MD, FACC

Study Questions:

What is the association between acute alcohol consumption and cardiac arrhythmias?

Methods:

The investigators enrolled 3,028 voluntary participants at the 2015 Munich Octoberfest, who received a smartphone-based electrocardiogram (ECG) and breath alcohol concentration (BAC) measurement. ECGs were analyzed for cardiac arrhythmias (sinus tachycardia, sinus arrhythmia, premature atrial/ventricular complexes, atrial fibrillation/flutter) and respiratory sinus arrhythmia. By multivariable adjusted logistic regression, the authors associated BACs with cardiac arrhythmias. Similarly, they analyzed 4,131 participants of the community-based KORA S4 Study (Co-operative Health Research in the Region of Augsburg) and associated cardiac arrhythmias with chronic alcohol consumption.

Results:

In the acute alcohol cohort (mean age 34.4 ± 13.3 years, 29% women), mean BAC was 0.85 ± 0.54 g/kg. Cardiac arrhythmias occurred in 30.5% (sinus tachycardia 25.9%; other arrhythmia subtypes 5.4%). Breath alcohol concentration was significantly associated with cardiac arrhythmias overall (odds ratio [OR] per 1-unit change, 1.75; 95% confidence interval [CI], 1.50-2.05; p < 0.001) and sinus tachycardia in particular (OR, 1.96; 95% CI, 1.66-2.31; p < 0.001). Respiratory sinus arrhythmia measuring autonomic tone was significantly reduced under the influence of alcohol. In KORA S4, chronic alcohol consumption was associated with sinus tachycardia (OR, 1.03; 95% CI, 1.01-1.06; p = 0.006).

Conclusions:

The authors concluded that acute alcohol consumption is associated with cardiac arrhythmias and sinus tachycardia in particular.

Perspective:

This observational, cross-sectional study reports a significant association of sinus tachycardia with acute alcohol intake occurring in more than a quarter of individuals. Furthermore, analysis of respiratory sinus arrhythmia as a measure of autonomic tone suggested that acute alcohol intake confers autonomic imbalance. Additional studies are needed to investigate if autonomic imbalance is the link between sinus tachycardia and the occurrence of arrhythmias like atrial fibrillation with alcohol intake.

Keywords: Alcohol Drinking, Alcoholism, Arrhythmia, Sinus, Arrhythmias, Cardiac, Atrial Fibrillation, Atrial Flutter, Atrial Premature Complexes, Electrocardiography, Tachycardia, Sinus


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