Abstract To the Editor. —Lowenstein et al1 recently described 40 cases of new-onset atrial fibrillation admitted to Denver General Hospital from the emergency room. They concluded that alcohol caused or contributed to 35% of the cases. Although there does seem to be some theoretical support for their proposition, there are methodological problems in their observational report that make the results uninterpretable. No attempt was made to establish causality by comparing cases of atrial fibrillation with an appropriate control group. Also, there was no adjustment for potentially confounding variables.Causality was established by declaration. The authors considered alcohol to be the cause of atrial fibrillation if the patient was intoxicated and no other cause could be identified, and considered alcohol to be a contributing cause if the patient was intoxicated and other known causes of atrial fibrillation were identified. Alcohol intoxication was present in 14 of 40 cases; therefore, the authors References 1. Lowenstein SR, Gabow PA, Cramer J, et al: The role of alcohol in new-onset atrial fibrillation. Arch Intern Med 1983;143:1882-1885.Crossref 2. Nolan JP: Alcohol as a factor in the illness of university service patients. Am J Med Sci 1965;249:135-142.Crossref 3. Barchha R, Stewart MA, Guze SB: The prevalence of alcoholism among general hospital ward patients. Am J Psychiatry 1968;125:681-684. 4. Green JR: The incidence of alcoholism in patients admitted to medical wards of a public hospital. Med J Aust 1965;1:465-466. 5. Whitfield CL, Williams K: The Patient With Alcoholism and Other Drug Problems , ed 3. Milwaukee, Medical College of Wisconsin, 1977.
Archives of Internal Medicine – American Medical Association
Published: Sep 1, 1984