A case-control study from Denmark showed that patients with acute ST-segment elevation myocardial infarction (STEMI) who consume more than seven servings of alcohol per week and drink regularly have an increased chance of developing ventricular fibrillation. The study was reported by Dr. Reza Jabbari (Rigshospitalet-Copenhagen University Hospital) at the 2014 American Heart Rhythm Society Annual Meeting. Compared with STEMI patients who did not drink alcohol, the risk of ventricular fibrillation was more than 1-fold higher with 8 to 14 drinks per week (OR 2.30, 95% CI 1.20 to 4.20) and more than 2-fold higher with more than 15 drinks per week (OR 3.30, 95% CI: 1.80 to 5.90). Jabbari noted at the meeting that both Danish and U.S. guidelines recommend that alcohol consumption should be moderate, with no more than two servings per day for men and no more than one serving per day for women. These criteria should be stricter, he said, especially for patients at high risk for heart attack or those with high-risk characteristics for ventricular fibrillation, as with a family history of sudden death. Jabbari noted that 3/4 of sudden cardiac deaths are due to coronary heart disease and myocardial infarction. The risk of myocardial infarction is reduced by consuming different doses of alcohol, but alcohol and sudden cardiac death are related in a U-shaped curve, and only moderate alcohol consumption can reduce the risk; excessive alcohol consumption has arrhythmogenic effects. Jabbari et al. included 650 patients aged 18-80 years from 4 Danish percutaneous coronary intervention (PCI) centers who had a first STEMI. After excluding patients with pre-existing ischemic heart disease before STEMI, a total of 219 patients with ventricular fibrillation before direct PCI and within 12 hours of symptom onset and 441 patients without arrhythmias were excluded. Patients completed questionnaires reporting the amount of alcohol they drank per week. Each was equivalent to 1 bottle of beer, or 1 serving of spirits (standard amount), or 1 glass of wine. The results showed that the median alcohol consumption was higher in patients who developed ventricular fibrillation (7 vs. 3 servings, p<0.001). Overall cardiovascular risk factors were similar in patients who developed and did not develop ventricular fibrillation, but the prevalence of hypercholesterolemia (40% vs. 32%) and atrial fibrillation (7% vs. 3%) was higher in patients who developed ventricular fibrillation. After adjusting for these differences and other common cardiovascular risk factors, a significant association between alcohol intake and ventricular fibrillation remained (P=0.001). An additional 1 serving of alcohol per week increased the relative risk of ventricular fibrillation by 2.4%; however, the risk of ventricular fibrillation did not continue to increase beyond 7 servings. II. Limitations of the study include: (1) patients who died before hospital admission were not included; (2) the type or pattern of alcohol consumption, such as alcohol abuse, was not considered; and (3) the inclusion of patients was limited to whites in Europe. Therefore, there is uncertainty in the generalization of the above study results.