Trial reportJACC. Clinical electrophysiology2021
A Randomized, Double-Blind, Placebo-Controlled Trial of Intravenous Alcohol to Assess Changes in Atrial Electrophysiology.
Trial report in JACC. Clinical electrophysiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 24 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Investigating the Effects of Ethanol on Atrial Fibrillation Susceptibility and Pathogenesis
Full-Avoidance vs. Permissive/Regulated Drinking & Outcomes On Fibrillation (FULL-PROOF)
Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 51 citations in OpenAlex.
- Guideline
- 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2024Guideline
- Environmental Exposures and Epigenetic Remodeling in Supraventricular Tachycardias: What Atrial Fibrillation Can and Cannot Tell Us.Life (Basel, Switzerland) · 2026Review
- Cardiac Responses to Alcohol: A Review of Mechanisms and Clinical Implications.Reviews in cardiovascular medicine · 2026Review
- Modifiable Lifestyle Factors, Left Atrial Indices, and Atrial Fibrillation.Journal of the American Heart Association · 2026Article
- Lifestyle modification in atrial fibrillation: Mechanisms, phenotypes and ablation outcomes.Experimental physiology · 2026Review
- Recent-onset atrial fibrillation: challenges and opportunities.European heart journal · 2026Review
- Sex Differences in Impacts of Alcohol Consumption on Prevalent Atrial Fibrillation.Journal of arrhythmia · 2025Article
- Alcohol Intake and Cardiovascular Outcomes in Patients With Atrial Fibrillation: RE-LY AF Registry Analysis.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2025Article
- Lifestyle and risk factor modification in atrial fibrillation: a European Heart Rhythm Association survey.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- The Role of Early Risk Factor Modification and Ablation in Atrial Fibrillation Substrate Remodeling Prevention.Biomedicines · 2025Review
- Impact of lifestyle risk factors on atrial fibrillation: Mechanisms and prevention approaches - A narrative review.International journal of cardiology. Cardiovascular risk and prevention · 2024Review
- Utility of smart watch in expediting diagnosis of cold drink-triggered atrial fibrillation: a case report.International journal of emergency medicine · 2024Article
- The Role of Risk Factor Modification in Atrial Fibrillation: Outcomes in Catheter Ablation.Journal of cardiovascular development and disease · 2024Review
- Drug-induced AF: Arrhythmogenic Mechanisms and Management Strategies.Arrhythmia & electrophysiology review · 2024Review
- Epidemiology and modifiable risk factors for atrial fibrillation.Nature reviews. Cardiology · 2023Review
- Article
- Alcohol and Atrial Fibrillation.Reviews in cardiovascular medicine · 2023Review
- Premature Atrial Contraction Location and Atrial Fibrillation Inducibility.Circulation. Arrhythmia and electrophysiology · 2023Article
- Clinical and Structural Factors Affecting Ablation Outcomes in Atrial Fibrillation Patients - A Review.Current cardiology reviews · 2023Review
Corrections and comments
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Authors and funding
22 authors at 4 institutions in 1 country.
Funding
Abstract
objectivesThis study sought to identify acute changes in human atrial electrophysiology during alcohol exposure.
backgroundThe mechanism by which a discrete episode of atrial fibrillation (AF) occurs remains unknown. Alcohol appears to increase the risk for AF, providing an opportunity to study electrophysiologic effects that may render the heart prone to arrhythmia.
methodsIn this randomized, double-blinded, placebo-controlled trial, intravenous alcohol titrated to 0.08% blood alcohol concentration was compared with a volume and osmolarity-matched, masked, placebo in patients undergoing AF ablation procedures. Right, left, and pulmonary vein atrial effective refractory periods (AERPs) and conduction times were measured pre- and post-infusion. Isoproterenol infusions and burst atrial pacing were used to assess AF inducibility.
resultsOf 100 participants (50 in each group), placebo recipients were more likely to be diabetic (22% vs. 4%; p = 0.007) and to have undergone a prior AF ablation (36% vs. 22%; p = 0.005). Pulmonary vein AERPs decreased an average of 12 ms (95% confidence interval: 1 to 22 ms; p = 0.026) in the alcohol group, with no change in the placebo group (p = 0.98). Whereas no statistically significant differences in continuously assessed AERPs were observed, the proportion of AERP sites tested that decreased with alcohol (median: 0.5; interquartile range: 0.6 to 0.6) was larger than with placebo (median: 0.4; interquartile range: 0.2 to 0.6; p = 0.0043). No statistically significant differences in conduction times or in the proportion with inducible AF were observed.
conclusionsAcute exposure to alcohol reduces AERP, particularly in the pulmonary veins. These data demonstrate a direct mechanistic link between alcohol, a common lifestyle exposure, and immediate proarrhythmic effects in human atria. (How Alcohol Induces Atrial Tachyarrhythmias Study [HOLIDAY]; NCT01996943).
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.