Alcohol and atrial fibrillation.

nize the close link between drinking alcohol and AF occurrence. In particular, it is commonly observed that AF occurs after excessive drinking. This phenomenon was first described as “holiday heart syndrome” in 1978 by Ettinger et al.7 Typically, this syndrome occurs in healthy individuals with heavy alcohol consumption who present with AF after a holiday or on weekends. This type of AF usually terminates within 24 h, suggesting the role of alcohol ingestion is a “transient trigger” for AF occurrence, typically linked to “binge” drinking. Several mechanisms for the role of alcohol ingestion as a transient trigger for AF have been suggested (Figure), including hyperadrenergic state (increased levels of serum catecholamines), impaired vagal tone (decreased heart rate variability), and cardiac conduction interference (prolongation of PRc, QRS and QTc).5 Irrespective of the widespread recognition of the arrhythmogenic effect after acute alcohol ingestion, the effect of chronic alcohol abuse on AF has been given less attention. Although trial fibrillation (AF) is the most common arrhythmia in developed countries. Several reports have noted that the AF population will greatly increase in the future corresponding with the rise in the age of society.1 Along with appropriate management of an arrhythmia that is closely associated with an increase in cardiovascular mortality and morbidity,2 primary AF prevention is of great interest, but requires appropriate identification of people at a high risk for AF. Well-known risk factors for AF include hypertension, type 2 diabetes, cardiovascular disease, obesity, metabolic syndrome and chronic kidney disease.3,4 Several studies have also identified that lifestyle characteristics, including smoking and alcohol consumption, are significantly linked to the incidence and/or prevalence of AF.5,6