Acute electrical, autonomic and structural effects of binge drinking : Insights into the 'holiday heart syndrome'
Copyright © 2021. Published by Elsevier B.V..
BACKGROUND: Binge drinking is a common atrial fibrillation (AF) trigger, however the mechanisms are poorly understood.
OBJECTIVE: To investigate the effects of alcohol intoxication and hangover with rhythm monitoring and cardiac MRI.
METHODS: Patients underwent serial cardiac MRI pre- and post-binge with continuous Holter monitoring. Time periods analyzed: baseline (24 h pre-binge), consumption, hangover (0- 24 h post-consumption) and post-hangover (24-48 h post-consumption).
RESULTS: 50 patients (age 49 ± 15 years, 40% paroxysmal AF) completed the study (intake 8.4 ± 3.1 standard drinks). Mean heart rate increased from 72 ± 10 to 80 ± 13 beats per minute (bpm) during consumption (p < 0.001). The hangover period was characterised by higher daily atrial ectopic count (50, IQR 10-132 vs baseline 43, IQR 10-113; p = 0.04) and reduced heart rate variability (SDNN 55 ms, IQR 40-65 versus 62 ms, IQR 51-66; p = 0.007). There was evidence of heightened parasympathetic activity post-hangover with heart rate slowing (mean HR 54 ± 6 bpm; p = 0.03) and increased activity in the High frequency band when separating the complex heart rate variability waveform into its component rhythms (291 ms2, 97-538 versus baseline 237 ms2, IQR 104-332; p = 0.04). Three patients developed AF 11, 29 and 34 h post-binge. Cardiac MRI (2.7 ± 0.7 days post-binge) demonstrated a decrease in left atrial (LA) emptying fraction (57.9 ± 8.5 to 53.5 ± 6.7%; p = 0.003) but no change in LA volume, left ventricular ejection fraction or markers of ventricular inflammation.
CONCLUSION: Binge drinking is associated with sympathetic activation followed by a 'rebound' parasympathetic response and atrial mechanical dysfunction which may explain the propensity and temporal association between binge drinking and AF.
| Errataetall: |
CommentIn: Int J Cardiol. 2021 Jun 1;332:87-88. - PMID 33662484 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:331 |
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| Enthalten in: |
International journal of cardiology - 331(2021) vom: 15. Mai, Seite 100-105 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Voskoboinik, Aleksandr [VerfasserIn] |
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| Links: |
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| Themen: |
Alcohol |
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| Anmerkungen: |
Date Completed 28.05.2021 Date Revised 28.05.2021 published: Print-Electronic CommentIn: Int J Cardiol. 2021 Jun 1;332:87-88. - PMID 33662484 Citation Status MEDLINE |
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| doi: |
10.1016/j.ijcard.2021.01.071 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM321089200 |
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| 100 | 1 | |a Voskoboinik, Aleksandr |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Acute electrical, autonomic and structural effects of binge drinking |b Insights into the 'holiday heart syndrome' |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
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| 500 | |a Date Completed 28.05.2021 | ||
| 500 | |a Date Revised 28.05.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Int J Cardiol. 2021 Jun 1;332:87-88. - PMID 33662484 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021. Published by Elsevier B.V. | ||
| 520 | |a BACKGROUND: Binge drinking is a common atrial fibrillation (AF) trigger, however the mechanisms are poorly understood | ||
| 520 | |a OBJECTIVE: To investigate the effects of alcohol intoxication and hangover with rhythm monitoring and cardiac MRI | ||
| 520 | |a METHODS: Patients underwent serial cardiac MRI pre- and post-binge with continuous Holter monitoring. Time periods analyzed: baseline (24 h pre-binge), consumption, hangover (0- 24 h post-consumption) and post-hangover (24-48 h post-consumption) | ||
| 520 | |a RESULTS: 50 patients (age 49 ± 15 years, 40% paroxysmal AF) completed the study (intake 8.4 ± 3.1 standard drinks). Mean heart rate increased from 72 ± 10 to 80 ± 13 beats per minute (bpm) during consumption (p < 0.001). The hangover period was characterised by higher daily atrial ectopic count (50, IQR 10-132 vs baseline 43, IQR 10-113; p = 0.04) and reduced heart rate variability (SDNN 55 ms, IQR 40-65 versus 62 ms, IQR 51-66; p = 0.007). There was evidence of heightened parasympathetic activity post-hangover with heart rate slowing (mean HR 54 ± 6 bpm; p = 0.03) and increased activity in the High frequency band when separating the complex heart rate variability waveform into its component rhythms (291 ms2, 97-538 versus baseline 237 ms2, IQR 104-332; p = 0.04). Three patients developed AF 11, 29 and 34 h post-binge. Cardiac MRI (2.7 ± 0.7 days post-binge) demonstrated a decrease in left atrial (LA) emptying fraction (57.9 ± 8.5 to 53.5 ± 6.7%; p = 0.003) but no change in LA volume, left ventricular ejection fraction or markers of ventricular inflammation | ||
| 520 | |a CONCLUSION: Binge drinking is associated with sympathetic activation followed by a 'rebound' parasympathetic response and atrial mechanical dysfunction which may explain the propensity and temporal association between binge drinking and AF | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Alcohol | |
| 650 | 4 | |a Atrial fibrillation | |
| 650 | 4 | |a Binge drinking | |
| 650 | 4 | |a Hangover | |
| 650 | 4 | |a Premature atrial contraction | |
| 700 | 1 | |a McDonald, Conor |e verfasserin |4 aut | |
| 700 | 1 | |a Chieng, David |e verfasserin |4 aut | |
| 700 | 1 | |a O'Brien, Jessica |e verfasserin |4 aut | |
| 700 | 1 | |a Gutman, Sarah |e verfasserin |4 aut | |
| 700 | 1 | |a Ngu, Phillip |e verfasserin |4 aut | |
| 700 | 1 | |a Sugumar, Hariharan |e verfasserin |4 aut | |
| 700 | 1 | |a Wong, Geoffrey |e verfasserin |4 aut | |
| 700 | 1 | |a Kalman, Jonathan M |e verfasserin |4 aut | |
| 700 | 1 | |a Taylor, Andrew J |e verfasserin |4 aut | |
| 700 | 1 | |a Kistler, Peter M |e verfasserin |4 aut | |
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