Octoberfest study suggests association between acute alcohol consumption and cardiac arrhythmias

An analysis conducted at the Munich Octoberfest found that acute alcohol consumption was associated with sinus tachycardia and other cardiac arrhythmias.

Lead researcher Stefan Brunner, MD, of University Hospital Munich in Germany, and colleagues published their results online in the European Heart Journal on April 26.

The observational study enrolled 3,028 healthy volunteers who were at least 18 years old and attended the 2015 Munich Octoberfest in Germany. All of the participants received a smartphone-based ECG and had their breath alcohol concentration (BAC) measured. The researchers considered this group as the acute alcohol cohort.

They also assessed the effect of chronic alcohol consumption on arrhythmia prevalence in a cohort of 4,131 adults who participated in Survey S4 of the community-based Cooperative Health Research in the region of Augsburg Study.

The researchers obtained ECG recordings with the smartphone-based AliveCor device in the acute alcohol cohort and with the Hannover ECG system in the chronic alcohol cohort. They determined BAC using the Drager Alcotest 7510 handheld device in the acute alcohol cohort and via a validated seven-day recall method in the chronic alcohol cohort.

The mean age was 34.7 years old in the acute alcohol cohort and 49.1 years old in the chronic alcohol cohort, while 29.9 percent and 51.1 percent of participants, respectively, were women. In addition, 69 percent and more than 99.5 percent of participants, respectively, were from Germany.

The primary outcome of any arrhythmia occurred in 30.5 percent of participants in the acute alcohol cohort and 2.7 percent of participants in the chronic alcohol cohort.

In the acute alcohol cohort, the most common arrhythmia was sinus tachycardia (occurring in 25.9 percent of participants), while 5.4 percent had other arrhythmias such as sinus arrhythmia, premature atrial and ventricular complexes and atrial fibrillation or flutter.

In the chronic alcohol cohort, 0.4 percent of participants had sinus tachycardia, while 2.3 percent had sinus arrhythmia, premature atrial and ventricular complexes and atrial fibrillation or flutter.

The researchers found that BAC was significantly associated with cardiac arrhythmias for men and women in the acute alcohol cohort. They also noted there was an association between sinus tachycardia and chronic alcohol consumption, but the effect size was much smaller than with acute alcohol consumption. They added that there were no associations with chronic alcohol consumption for other arrhythmias or a combination of sinus tachycardia with other arrhythmia subtypes.

The study had a few limitations, according to the researchers, including that they did not conduct physical examinations and could not ask many personal questions due to the public nature of the Munich Octoberfest. Thus, they noted that they could not address potential confounders such as the amount of alcohol consumption before measuring BAC, the participants’ normal alcohol consumption, their use of recreational drugs and their typical physical activity. In addition, they only took one ECG recording and could not assess the incidence of arrhythmias during the follow-up period.

“Acute and—to a lesser extent—chronic alcohol consumption were associated with sinus tachycardia. Analysis of respiratory sinus arrhythmia as a measure of autonomic tone suggested that acute alcohol intake confers autonomic imbalance. Additional research is warranted to investigate if autonomic imbalance constitutes the link between sinus tachycardia and the occurrence of arrhythmias like atrial fibrillation, as implicated by reports of the so-called ‘Holiday Heart Syndrome.’”