ECG-voltage in alcoholics and non-alcoholics with acute alcohol intoxication

Alcohol intoxication is probably the most common intoxication worldwide, and may be lethal. The exact mechanism by which ethanol intoxication contributes to death is unknown, although ventricular tachyarrhythmias degenerating into fibrillation is a possible cause. Alcoholics have increased risk of sudden death and, possibly, higher risk than occasional drinkers. In 32 consecutive patients with alcohol intoxication Delta-voltage was the differences in voltage between values at admission (when patients had high blood alcohol levels) and at discharge (when the patients were assumed sober), and was calculated for QRS complexes and T-waves in precordial and bipolar leads. Delta-precordial-QRS-voltage was positive in 13/15 (87%, p = 0.010) of the occasional drinkers and in 8/17 (47%, p = 0.53) of the alcoholics (alcoholics vs. occasional drinkers: p = 0.008). Both Delta-precordial-QRS-voltage and Delta-precordial-T-wave-voltage differed from the group of occasional drinkers to the group of alcoholics, after adjusting for age, sex and sosmolality. Mean alcohol concentration was 0.29%. Conclusions have to be made with caution. Alcohol in potential lethal blood concentrations seems to increase ECG-voltages in occasional drinkers but not in alcoholics. This indicates that alcohol interferes with the ion channels that create the action potentials of the heart, but in alcoholics an adaptation process has occurred. (c) 2009 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.