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Erschienen in: Herz 6/2016

31.08.2016 | Vorhofflimmern | Schwerpunkt

Alkohol und Rhythmusstörungen

verfasst von: Prof. Dr. D. Pfeiffer, D. Jurisch, M. Neef, A. Hagendorff

Erschienen in: Herz | Ausgabe 6/2016

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Zusammenfassung

Die Auswirkungen von Alkohol auf Arrhythmien sind dosisabhängig, unabhängig vom Nachweis einer kardiovaskulären Erkrankung oder einer Herzinsuffizienz und können Gesunde betreffen. Während Vorhofflimmern in seiner Wahrscheinlichkeit mit der Alkoholdosis zunimmt, kommen Ereignisse des plötzlichen Herztodes bei niedrigen Alkoholdosierungen eher seltener, jedoch bei höherer Alkoholmenge unter alkoholischer Kardiomyopathie häufiger vor. Männer sind erst bei höheren Alkoholmengen betroffen, Frauen zeigen bereits bei niedrigeren Dosierungen Rhythmusstörungen. Thromboembolien und ischämische Schlaganfälle können bei niedriger Dosierung des Alkohols seltener auftreten, jedoch nehmen hämorrhagische Insulte und intrakranielle Blutungen mit der Alkoholdosis zu. Erkennbare protektive Mechanismen von Alkohol hinsichtlich der kardiovaskulären Morbidität betreffen ausschließlich geringe Alkoholmengen von weniger als 10 g/Tag. Zugrunde liegende Mechanismen erklären die kontroversen Ergebnisse. Spezifische therapeutische Möglichkeiten alkoholbedingter Arrhythmien über eine Alkoholkarenz hinaus sind nicht bekannt.
Literatur
1.
Zurück zum Zitat Briasoulis A, Agarwal V, Messerli FH (2012) Alcohol consumption and the risk of hypertension in men and women. A systematic review and meta analysis. J Clin Hypertens 14:792–798CrossRef Briasoulis A, Agarwal V, Messerli FH (2012) Alcohol consumption and the risk of hypertension in men and women. A systematic review and meta analysis. J Clin Hypertens 14:792–798CrossRef
2.
Zurück zum Zitat Mukamal KJ, Tolstrup JC, Friberg J et al (2005) Alcohol consumption and risk of atrial fibrillation in men and women. The Copenhagen City Heart study. Circulation 112:1736–1742CrossRefPubMed Mukamal KJ, Tolstrup JC, Friberg J et al (2005) Alcohol consumption and risk of atrial fibrillation in men and women. The Copenhagen City Heart study. Circulation 112:1736–1742CrossRefPubMed
3.
Zurück zum Zitat US Department of Health and Human Service (2008) The Physicians Guide to helping patients with alcohol problems. NIH Publication, Washington DC, S 95–3769 US Department of Health and Human Service (2008) The Physicians Guide to helping patients with alcohol problems. NIH Publication, Washington DC, S 95–3769
4.
Zurück zum Zitat Carrao G, Rubbiato L, Bagnardi V et al (2000) Alcohol and coronary heart disease: A meta analysis. Addiction 95:1505–1523CrossRef Carrao G, Rubbiato L, Bagnardi V et al (2000) Alcohol and coronary heart disease: A meta analysis. Addiction 95:1505–1523CrossRef
5.
Zurück zum Zitat Klatsky AL (2015) Alcohol and cardiovascular diseases. Where do we stand today? J Intern Med 278:238–250CrossRefPubMed Klatsky AL (2015) Alcohol and cardiovascular diseases. Where do we stand today? J Intern Med 278:238–250CrossRefPubMed
6.
Zurück zum Zitat Conen D, Chae CU, Glynn RJ et al (2011) Risk of death and cardiovascular events in initially healthy women with new onset atrial fibrillation. J Am Med Assoc 305:2080–2087CrossRef Conen D, Chae CU, Glynn RJ et al (2011) Risk of death and cardiovascular events in initially healthy women with new onset atrial fibrillation. J Am Med Assoc 305:2080–2087CrossRef
7.
Zurück zum Zitat Conen D (2015) Alcohol consumption and incident cardiovascular disease. Not just one unifying hypothesis. Eur Heart J 36:897–898CrossRefPubMed Conen D (2015) Alcohol consumption and incident cardiovascular disease. Not just one unifying hypothesis. Eur Heart J 36:897–898CrossRefPubMed
8.
Zurück zum Zitat Larsson SC, Drca N, Wolk A (2014) Alcohol consumption and risk of atrial fibrillation. A prospective study and dose response meta analysis. J Am Coll Cardiol 64:281–289CrossRefPubMed Larsson SC, Drca N, Wolk A (2014) Alcohol consumption and risk of atrial fibrillation. A prospective study and dose response meta analysis. J Am Coll Cardiol 64:281–289CrossRefPubMed
9.
Zurück zum Zitat Horton JW, White JD (1996) Cardiac contractile and sarcoplasmatic reticulum function after ethanol consumption. J Surg Res 64:132–138CrossRefPubMed Horton JW, White JD (1996) Cardiac contractile and sarcoplasmatic reticulum function after ethanol consumption. J Surg Res 64:132–138CrossRefPubMed
10.
Zurück zum Zitat Guarnieri T, Lakatta EG (1990) Mechanism of myocardial contractile depression by clinical concentration of ethanol. J Clin Invest 85:1462–1467CrossRefPubMedPubMedCentral Guarnieri T, Lakatta EG (1990) Mechanism of myocardial contractile depression by clinical concentration of ethanol. J Clin Invest 85:1462–1467CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Balbao CEB, Paola AAV de, Fenelon G (2009) Effect of alcohol on atrial fibrillation: Myths and truths. Ther Adv Cardiovasc Dis 3(1):53–63CrossRefPubMed Balbao CEB, Paola AAV de, Fenelon G (2009) Effect of alcohol on atrial fibrillation: Myths and truths. Ther Adv Cardiovasc Dis 3(1):53–63CrossRefPubMed
12.
Zurück zum Zitat Patel VC, Why HJ, Richardson PJ, Preedy VR (1997) The effect of alcohol on the heart. Adverse Drug React Toxicol Rev 16:15–43PubMed Patel VC, Why HJ, Richardson PJ, Preedy VR (1997) The effect of alcohol on the heart. Adverse Drug React Toxicol Rev 16:15–43PubMed
13.
Zurück zum Zitat Ettinger PO, Wu CF, Jr De la Cruz C et al (1978) Arrhythmias and the „holiday heart“: Alcohol-associated cardiac rhythm disorders. Am Heart J 95(5):555–562CrossRefPubMed Ettinger PO, Wu CF, Jr De la Cruz C et al (1978) Arrhythmias and the „holiday heart“: Alcohol-associated cardiac rhythm disorders. Am Heart J 95(5):555–562CrossRefPubMed
15.
Zurück zum Zitat Menz V, Grimm W, Hoffmann J, Maisch B (1996) Alkohol und Rhythmusstörungen: Das Holiday-Heart Syndrom. Herz 21(4):227–231PubMed Menz V, Grimm W, Hoffmann J, Maisch B (1996) Alkohol und Rhythmusstörungen: Das Holiday-Heart Syndrom. Herz 21(4):227–231PubMed
16.
Zurück zum Zitat Cohen EJ, Klatsky AL, Armstrong MA (1988) Alcohol use and supraventricular arrhythmias. Am J Cardiol 62:971–973CrossRefPubMed Cohen EJ, Klatsky AL, Armstrong MA (1988) Alcohol use and supraventricular arrhythmias. Am J Cardiol 62:971–973CrossRefPubMed
19.
Zurück zum Zitat Kodavali L, Townsend RR (2006) Alcohol and its relationship to blood pressure. Curr Hypertens Rep 8:338–344CrossRefPubMed Kodavali L, Townsend RR (2006) Alcohol and its relationship to blood pressure. Curr Hypertens Rep 8:338–344CrossRefPubMed
20.
Zurück zum Zitat Klatsky AL, Friedman GD, Siegelaub AB, Gérard MJ (1977) Alcohol consumption and blood pressure. N Engl J Med 296:1194–2000CrossRefPubMed Klatsky AL, Friedman GD, Siegelaub AB, Gérard MJ (1977) Alcohol consumption and blood pressure. N Engl J Med 296:1194–2000CrossRefPubMed
21.
Zurück zum Zitat Zilkens RR, Burke V, Hodgson JM et al (2005) Red wine and beer elevate blood pressure in normotensive men. Hypertension 5:874–879CrossRef Zilkens RR, Burke V, Hodgson JM et al (2005) Red wine and beer elevate blood pressure in normotensive men. Hypertension 5:874–879CrossRef
22.
23.
Zurück zum Zitat Moe GK, Abildskov JA (1959) Atrial fibrillation as a self-sustaining arrhythmia independent of focal discharge. Am Heart J 58:59–70CrossRefPubMed Moe GK, Abildskov JA (1959) Atrial fibrillation as a self-sustaining arrhythmia independent of focal discharge. Am Heart J 58:59–70CrossRefPubMed
24.
Zurück zum Zitat Gimeno AL, Gimenon MF, Webb JL (1962) Effect of ethanol on cellular membrane potentials and contractility of isolated rat atrium. Am J Physiol 203:194–196PubMed Gimeno AL, Gimenon MF, Webb JL (1962) Effect of ethanol on cellular membrane potentials and contractility of isolated rat atrium. Am J Physiol 203:194–196PubMed
25.
Zurück zum Zitat Engel TR, Luck JC (1983) Effect of whiskey on atrial vulnerability and holiday heart. J Am Coll Cardiol 1:816–818CrossRefPubMed Engel TR, Luck JC (1983) Effect of whiskey on atrial vulnerability and holiday heart. J Am Coll Cardiol 1:816–818CrossRefPubMed
26.
Zurück zum Zitat Wiener N, Rosenblueth A (1946) The mathematical formulation of the problem of conduction of impulses in a network of connected excitable elements, specifically in cardiac muscle. Arch Inst Cardiol Mex 16:382–389 Wiener N, Rosenblueth A (1946) The mathematical formulation of the problem of conduction of impulses in a network of connected excitable elements, specifically in cardiac muscle. Arch Inst Cardiol Mex 16:382–389
27.
Zurück zum Zitat Williams ES, Mirro MJ, Bailey JC (1980) Electrophysiological effects of ethanol, acetaldehyde, and acetate on cardiac tissues from dog and guinea pig. Circ Res 47:473–478CrossRefPubMed Williams ES, Mirro MJ, Bailey JC (1980) Electrophysiological effects of ethanol, acetaldehyde, and acetate on cardiac tissues from dog and guinea pig. Circ Res 47:473–478CrossRefPubMed
28.
Zurück zum Zitat Carpentier RG, Gallardo-Carpentier A (1987) Acute and chronic effects of ethanol in sinuatrial electrophysiology in the rat heart. J Cardiovasc Pharmacol 10:616–621CrossRefPubMed Carpentier RG, Gallardo-Carpentier A (1987) Acute and chronic effects of ethanol in sinuatrial electrophysiology in the rat heart. J Cardiovasc Pharmacol 10:616–621CrossRefPubMed
29.
Zurück zum Zitat Jain AK, Carpentier RG (1998) Cardiac electrophysiological actions and interactions of ethanol, cocaine and the metabolic ethylcocaine. J Electrophysiol 31:293–302 Jain AK, Carpentier RG (1998) Cardiac electrophysiological actions and interactions of ethanol, cocaine and the metabolic ethylcocaine. J Electrophysiol 31:293–302
30.
Zurück zum Zitat Chen YC, Chen SA, Chen YJ et al (2004) Effect of ethanol on the electrophysiological characteristics of pulmonary vein cardiomyocytes. Eur J Pharmacol 483:215–222CrossRefPubMed Chen YC, Chen SA, Chen YJ et al (2004) Effect of ethanol on the electrophysiological characteristics of pulmonary vein cardiomyocytes. Eur J Pharmacol 483:215–222CrossRefPubMed
31.
Zurück zum Zitat Fenelon G, Balbao CEB, Fernandes R et al (2007) Characterization of the acute cardiac electrophysiologic effects of ethanol in dogs. Alcohol Clin Exp Res 31:1574–1580CrossRefPubMed Fenelon G, Balbao CEB, Fernandes R et al (2007) Characterization of the acute cardiac electrophysiologic effects of ethanol in dogs. Alcohol Clin Exp Res 31:1574–1580CrossRefPubMed
32.
Zurück zum Zitat Mäki T, Toivonen L, Koskinen P et al (1998) Effect of ethanol drinking, hangover and exercise on adrenergic activity and heart rate variability in patients with a history of alcohol-induced atrial fibrillation. Am J Cardiol 82(3):317–322CrossRefPubMed Mäki T, Toivonen L, Koskinen P et al (1998) Effect of ethanol drinking, hangover and exercise on adrenergic activity and heart rate variability in patients with a history of alcohol-induced atrial fibrillation. Am J Cardiol 82(3):317–322CrossRefPubMed
33.
Zurück zum Zitat Mandyam MC, Vedantham V, Scheinman MM et al (2012) Alcohol and vagal tone as triggers for paroxysmal atrial fibrillation. Am J Cardiol 110(3):364–368CrossRefPubMedPubMedCentral Mandyam MC, Vedantham V, Scheinman MM et al (2012) Alcohol and vagal tone as triggers for paroxysmal atrial fibrillation. Am J Cardiol 110(3):364–368CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat Kostis JB, Goodkind J, Skavaya H et al (1977) Effect of alcohol on the atrial fibrillation threshold on dogs. Angiol J Vasc Dis 28:583–587 Kostis JB, Goodkind J, Skavaya H et al (1977) Effect of alcohol on the atrial fibrillation threshold on dogs. Angiol J Vasc Dis 28:583–587
35.
Zurück zum Zitat Benjamin EJ, Levy D, Vaziri SM et al (1994) Independent risk factors for atrial fibrillation in a population-based cohort: The Framingham heart study. J Am Med Assoc 271:840–844CrossRef Benjamin EJ, Levy D, Vaziri SM et al (1994) Independent risk factors for atrial fibrillation in a population-based cohort: The Framingham heart study. J Am Med Assoc 271:840–844CrossRef
36.
Zurück zum Zitat Krahn AD, Manfreda J, Tate RB et al (1995) The natural history of atrial fibrillation: Incidence, risk factors and prognosis in the Manitoba follow-up study. Am J Cardiol 98:476–484 Krahn AD, Manfreda J, Tate RB et al (1995) The natural history of atrial fibrillation: Incidence, risk factors and prognosis in the Manitoba follow-up study. Am J Cardiol 98:476–484
37.
Zurück zum Zitat Wilhelmsen L, Rosengren A, Lappas G (2001) Hospitalization for atrial fibrillation In the general male population: Morbidity and risk factors. J Intern Med 250:382–389CrossRefPubMed Wilhelmsen L, Rosengren A, Lappas G (2001) Hospitalization for atrial fibrillation In the general male population: Morbidity and risk factors. J Intern Med 250:382–389CrossRefPubMed
38.
Zurück zum Zitat Stewart S, Hart CL, Hole DJ, McMurry JJ (2001) Population prevalence, incidence and predictors of atrial fibrillation in the Renfrew/Paisley study. Heart 86:516–521CrossRefPubMedPubMedCentral Stewart S, Hart CL, Hole DJ, McMurry JJ (2001) Population prevalence, incidence and predictors of atrial fibrillation in the Renfrew/Paisley study. Heart 86:516–521CrossRefPubMedPubMedCentral
39.
Zurück zum Zitat Psaty BM, Manolio TA, Kuller LH et al (1997) Incidence of and risk factors for atrial fibrillation in older adults. Circulation 96:2455–2461CrossRefPubMed Psaty BM, Manolio TA, Kuller LH et al (1997) Incidence of and risk factors for atrial fibrillation in older adults. Circulation 96:2455–2461CrossRefPubMed
40.
Zurück zum Zitat Frost L, Vestergaard P (2004) Alcohol and risk of atrial fibrillation or flutter – a cohort study. Arch Intern Med 164:1993–1998CrossRefPubMed Frost L, Vestergaard P (2004) Alcohol and risk of atrial fibrillation or flutter – a cohort study. Arch Intern Med 164:1993–1998CrossRefPubMed
41.
Zurück zum Zitat Djousse L, Levy D, Benjamin EJ et al (2004) Long term alcohol consumption and the risk of atrial fibrillation in the Framingham study. Am J Cardiol 93:710–713CrossRefPubMed Djousse L, Levy D, Benjamin EJ et al (2004) Long term alcohol consumption and the risk of atrial fibrillation in the Framingham study. Am J Cardiol 93:710–713CrossRefPubMed
42.
Zurück zum Zitat Guize L, Thomas F, Bean K et al (2007) Fibrillation atriale: Prevalence, facteurs de risqué et mortalité dans une vaste population francaise suive 15 ans. Bull Acad Natl Med 191:791–803PubMed Guize L, Thomas F, Bean K et al (2007) Fibrillation atriale: Prevalence, facteurs de risqué et mortalité dans une vaste population francaise suive 15 ans. Bull Acad Natl Med 191:791–803PubMed
43.
Zurück zum Zitat Mukamal KJ, Psaty BM, Rautaharju PM et al (2007) Alcohol consumption and risk and prognosis of atrial fibrillation among older adults: The cardiovascular Health study. Am Heart J 153:260–266CrossRefPubMed Mukamal KJ, Psaty BM, Rautaharju PM et al (2007) Alcohol consumption and risk and prognosis of atrial fibrillation among older adults: The cardiovascular Health study. Am Heart J 153:260–266CrossRefPubMed
44.
Zurück zum Zitat Planas VR, Romero-Menor C, Vasquez Oliva G et al (2006) Historia natural y factores de riesgo de recurrencia de la fibrillation auricular primaria (Registro FAP). Rev Esp Cardiol 59:1106–1112CrossRefPubMed Planas VR, Romero-Menor C, Vasquez Oliva G et al (2006) Historia natural y factores de riesgo de recurrencia de la fibrillation auricular primaria (Registro FAP). Rev Esp Cardiol 59:1106–1112CrossRefPubMed
45.
Zurück zum Zitat Greenspon AJ, Schaal SF (1983) The holiday heart: Electrophysiologic studies of alcohol effects in alcoholics. Ann Intern Med 98:135–139CrossRefPubMed Greenspon AJ, Schaal SF (1983) The holiday heart: Electrophysiologic studies of alcohol effects in alcoholics. Ann Intern Med 98:135–139CrossRefPubMed
46.
Zurück zum Zitat Gould L, Reddy CV, Becker W et al (1978) Electrophysiologic properties of alcohol in men. J Electrocardiol 11:219–226CrossRefPubMed Gould L, Reddy CV, Becker W et al (1978) Electrophysiologic properties of alcohol in men. J Electrocardiol 11:219–226CrossRefPubMed
47.
Zurück zum Zitat Denison H, Jern S, Jagenburg R et al (1994) Influence of increased adrenergic activity and magnesium depletion on cardiac rhythm in alcohol withdrawal. Br Heart J 72:554–560CrossRefPubMedPubMedCentral Denison H, Jern S, Jagenburg R et al (1994) Influence of increased adrenergic activity and magnesium depletion on cardiac rhythm in alcohol withdrawal. Br Heart J 72:554–560CrossRefPubMedPubMedCentral
48.
Zurück zum Zitat Gribaldo RG, Pomoni GS, Sale F (1985) Arrhythmias and left ventricular function in chronic alcoholics with cirrhosis. Am Heart J 56: 825:827 Gribaldo RG, Pomoni GS, Sale F (1985) Arrhythmias and left ventricular function in chronic alcoholics with cirrhosis. Am Heart J 56: 825:827
49.
Zurück zum Zitat Uyarel HOC, Karabulut A, Okmen E, Cam N (2005) Acute alcohol intake and P wave dispersion in healthy man. Anadolu Kardiyol Derg 5:289–293PubMed Uyarel HOC, Karabulut A, Okmen E, Cam N (2005) Acute alcohol intake and P wave dispersion in healthy man. Anadolu Kardiyol Derg 5:289–293PubMed
50.
Zurück zum Zitat Goodking MJ, Gerber NH, Mellen JR, Kostis JB (1975) Altered intracardiac conduction after acute administration of ethanol in the dog. J Pharmacol Exper Ther 194:633–638 Goodking MJ, Gerber NH, Mellen JR, Kostis JB (1975) Altered intracardiac conduction after acute administration of ethanol in the dog. J Pharmacol Exper Ther 194:633–638
51.
Zurück zum Zitat Lorsheyd A, deLange DW, Hijmering ML et al (2005) PR and QTc interval prolongation on the electrocardiogram after binge drinking in healthy individuals. Neth J Med 63:59–63PubMed Lorsheyd A, deLange DW, Hijmering ML et al (2005) PR and QTc interval prolongation on the electrocardiogram after binge drinking in healthy individuals. Neth J Med 63:59–63PubMed
52.
Zurück zum Zitat Stampfer MJ, Colditz GA, Willett WC et al (1988) Prospective study of moderate alcohol consumption and the risk of coronary artery disease and stroke in women. N Engl J Med 319:267–271CrossRefPubMed Stampfer MJ, Colditz GA, Willett WC et al (1988) Prospective study of moderate alcohol consumption and the risk of coronary artery disease and stroke in women. N Engl J Med 319:267–271CrossRefPubMed
53.
Zurück zum Zitat Iso H, Baba S, Mannami T (2004) Alcohol consumption and risk of stroke among middle-aged men: The JPHC study. Cohort I. Stroke 35:1124–1129CrossRefPubMed Iso H, Baba S, Mannami T (2004) Alcohol consumption and risk of stroke among middle-aged men: The JPHC study. Cohort I. Stroke 35:1124–1129CrossRefPubMed
55.
Zurück zum Zitat Klatsky AL, Armstrong MA, Friedman GD, Sidney S (2002) Alcohol and risk of hemorrhagic stroke. Neuroepidemiology 21:115–122CrossRefPubMed Klatsky AL, Armstrong MA, Friedman GD, Sidney S (2002) Alcohol and risk of hemorrhagic stroke. Neuroepidemiology 21:115–122CrossRefPubMed
Metadaten
Titel
Alkohol und Rhythmusstörungen
verfasst von
Prof. Dr. D. Pfeiffer
D. Jurisch
M. Neef
A. Hagendorff
Publikationsdatum
31.08.2016
Verlag
Springer Medizin
Erschienen in
Herz / Ausgabe 6/2016
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI
https://doi.org/10.1007/s00059-016-4463-z

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