PE-040 : Increased Risk for Developing Atrial Fibrillation or Flutter in Hepatitis B Carriers: A Population-based Follow-Up Study

Aims: Recent studies have revealed significant associations between atrial fibrillation (Afib) or flutter (AF) and hepatic disorders such as non-alcoholic fatty liver disease and chronic hepatitis C. In this study, we hypothesized that chronic hepatitis B virus (HBV) infection would increase the risk of Afib/AF. Methods: To test this hypothesis, we used data from 43,255 adults (>19 years) who had periodic preventive medical checkups from 2005 to 2009 at the Health Screening and Promotion Center at Asan Medical Center and were followed up longer than one year. All subjects received a comprehensive health assessment, and their results were obtained through the institution’s Information Technology of Service Management system. Information on past medical history, smoking and alcohol consumption, and current drug history were extracted from standardized questionnaire responses. Electrocardiograms, based on which the diagnosis of irregular heartbeats was made, were available for all patients at baseline and at every checkup during follow-up (median: 4 tests/person). Results: In the baseline examination, 1,995 subjects were chronically infected with HBV, and 41,260 did not have hepatitis B or C. After 1:4 propensity score matching, 1,995 HBV carriers and 7,975 controls without any viral hepatitis were finally constructed. Over a mean follow-up time of 6.5±3.5 years, Afib/AF was observed in 18 HBV carriers (0.9%) and 38 controls (0.48%) (P<0.05). Multivariate Cox analysis also showed that patients with hepatitis B had a significantly higher incidence of Afib/AF [adjusted hazard ratio (HR), 1.679], as did men (2.692), the elderly (1.080), obese individuals (1.966), and heavy drinkers (1.866) (Ps<0.05). For HBV carriers, heavy alcohol consumption (≥4 times/week) was the only factor independently correlated with the development of Afib/AF (adjusted HR, 4.997; P<0.05). Conclusions: We found that chronic HBV infection carried increased risk of Afib/AF. The best way to prevent atrial arrhythmia in HBV carriers could be to quit drinking.