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April 1984

The Role of Alcohol in New-Onset Atrial Fibrillation-Reply

Arch Intern Med. 1984;144(4):863. doi:10.1001/archinte.1984.00350160232048

In Reply.  —Our recent article emphasized the association of alcohol intoxication and acute AF. We appreciate the comments made by Dr Spodick, an authority.In our article, we suggested that the differential diagnosis of new-onset AF should be expanded to include alcohol intoxication; indeed, in our study, the traditional components of that differential diagnosis (ie, mitral stenosis, thyrotoxicosis, and pericarditis) occurred relatively infrequently. Spodick's articles provide additional data. His first comment calls into question the statement concerning the "well-recognized association of AF and pericarditis. "1(p1882) In that prospective study of 100 patients with acute pericarditis, only five patients demonstrated AF; all had organic heart disease.2 In an earlier study, however, Soffer3 observed transient episodes of AF in 13% of patients with acute pericarditis.An earlier study by Spodick et al4 reviewed the ECGs of 301 patients with emphysema; AF was present in only ten patients (3.3%). All of