Alcohol Abstinence and Atrial Fibrillation
What is the effect of abstinence from alcohol on secondary prevention of atrial fibrillation?
This was a multicenter, prospective, open-label, randomized, controlled trial at six hospitals in Australia. Adults who consumed 10 or more standard drinks (with 1 standard drink containing approximately 12 g of pure alcohol) per week and who had paroxysmal or persistent atrial fibrillation in sinus rhythm at baseline were randomly assigned in a 1:1 ratio to either abstain from alcohol or continue their usual alcohol consumption. The two primary endpoints were freedom from recurrence of atrial fibrillation (after a 2-week “blanking period”) and total atrial fibrillation burden (proportion of time in atrial fibrillation) during 6 months of follow-up.
A total of 140 patients underwent randomization. Patients in the abstinence group reduced their alcohol intake from 17 to 2 standard drinks per week (a reduction of ~88%), and patients in the control group reduced their alcohol intake from 16 to 13 drinks per week (a reduction of ~20%). Atrial fibrillation recurred in 53% of patients in the abstinence group and in 73% of patients in the control group. The abstinence group had a longer period before recurrence than the control group. The atrial fibrillation burden over 6 months of follow-up was significantly lower in the abstinence group than in the control group.
Abstinence from alcohol reduced arrhythmia recurrences in regular drinkers with atrial fibrillation.
The authors demonstrated that among heavy drinkers, a substantial reduction in alcohol consumption by patients with symptomatic atrial fibrillation was associated with a reduction in recurrence of atrial fibrillation and a reduced proportion of time spent in atrial fibrillation. Difficulty in identifying patients willing to consider abstinence for this study highlights the challenge in clinical practice for patients to follow abstinence if recommended by their physician, but those patients who do comply with abstinence will likely experience less recurrent atrial fibrillation. Of note, population studies suggest that light-to-moderate alcohol consumption is associated with a lower incidence of coronary artery disease and cardiovascular events. Future work in this area should examine the effect of alcohol abstinence on recurrent atrial fibrillation in patients with more moderate alcohol consumption.
Keywords: Arrhythmias, Cardiac, Alcohol Abstinence, Alcohol Drinking, Alcoholic Intoxication, Atrial Fibrillation, Coronary Artery Disease, Secondary Prevention
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