Acute alcohol exposure and electrocardiographic changes: Finding from the HOLIDAY trial

Area of Science:

• Cardiology
• Electrophysiology
• Pharmacology

Background:

• Alcohol consumption is a known risk factor for atrial fibrillation (AF).
• The acute effects of alcohol on human cardiac electrophysiology are not well understood.
• Previous studies suggest alcohol shortens atrial refractory periods, but surface ECG changes are unreported.

Purpose of the Study:

• To investigate the acute effects of alcohol on cardiac electrophysiology using surface ECG.
• To analyze global electrophysiologic changes in response to alcohol infusion.

Main Methods:

• Secondary analysis of the HOw ALcohol InDuces Atrial TachYarrhythmias (HOLIDAY) Trial.
• 100 adults undergoing AF ablation were randomized to intravenous alcohol (0.08% BAC) or placebo.
• 12-lead ECG intervals were compared pre-infusion and at steady state (20 min).

Main Results:

• No significant differences in P-wave, PR, QRS, or QT intervals between groups.
• Alcohol infusion was associated with a statistically significant relative shortening of the JT interval (p=0.048).
• This shortening of the JT interval reflects reduced ventricular repolarization.

Conclusions:

• Acute alcohol exposure is linked to a relative reduction in the JT interval.
• This suggests a shortening of ventricular repolarization.
• These findings indicate potential immediate proarrhythmic effects in both atria and ventricles.