We read with interest the meta-analysis on alcohol consumption and risk of atrial fibrillation (AF) by Kodama and coworkers (1). However, several characteristics of our prior publication that are mentioned in Table 1 of the meta-analysis are in need of clarification (2). First, the Women's Health Study is a prospective cohort study among female health professionals in the United States, not Switzerland (3). Second, the predominant AF pattern in the Women's Health Study is actually paroxysmal AF, not chronic AF, with about two-thirds of the participants with new-onset AF having paroxysmal AF. Third, AF diagnosis was not based on participants' reports, but all cases were confirmed by medical record review. Based on these corrections, the analyses stratified by these variables presented in Table 2 should be modified.

In addition, we would like to suggest an additional analysis for the authors' consideration. Although sex did not modify the relationship between alcohol and AF when the results comparing extremes of intake were combined in Table 2, the extreme levels of alcohol intake were generally lower among women as compared with men in these studies. Indeed, prior studies have suggested that the level of alcohol intake at which AF risk elevates may be substantially lower among women (about 2 drinks per day) as compared with men (about 4 to 5 drinks per day) (2,4- 5). Therefore, it would be of interest to see the dose-response relationship between alcohol consumption and AF risk presented in Figure 4 stratified by sex.