Heavy alcohol use has been suspected to cause acute atrial fibrillation, but an 
association between these two common problems has never been demonstrated. We 
retrospectively reviewed 64 cases with idiopathic acute atrial fibrillation and 
64 age- and sex-matched controls, randomly selected from among general medical 
admissions. Sixty-two percent of cases and 33% of controls had documentation as 
heavy users of alcohol. Furthermore, patients with alcohol-related atrial 
fibrillation were significantly more likely to manifest alcohol withdrawal 
syndrome than were other inpatients with heavy alcohol use. Patients with 
alcohol-related acute atrial fibrillation were not different from other patients 
with acute atrial fibrillation with respect to clinical evidence of congestive 
heart failure, electrocardiographic abnormalities, cardiomegaly, electrolyte 
disturbance, or response to therapy. Heavy alcohol use is an important potential 
etiology for acute atrial fibrillation; alcohol withdrawal may represent a 
particular risk for such alcohol-related atrial fibrillation.