Alcohol Consumption Reduction and Clinical Outcomes of Catheter Ablation for Atrial Fibrillation

Abstract

Background - Abstinence from alcohol is effective for reduction of atrial fibrillation (AF) burden. However, effects of alcohol abstinence on clinical outcomes of catheter ablation for AF remain unknown. We sought to assess association of alcohol consumption reduction with clinical outcomes of catheter ablation for AF. Methods - In this multicenter prospective observational study, consecutive patients undergoing catheter ablation for AF were enrolled. All patients were requested to limit alcohol consumption to <20g per week after the ablation. The primary endpoint was AF/atrial tachycardia (AT) recurrence-free survival without antiarrhythmic drugs beyond a 3-month blanking period. Percent reduction of alcohol consumption from baseline to 1-year post-ablation, if freed from AF/AT for 1-year, or to AF/AT recurrence was assessed. Univariate and multivariate Cox regression analyses were performed to assess the association of the percent reduction of alcohol consumption with AF/AT recurrence-free survival as well as to determine the cutoff value for the percent reduction of alcohol consumption that yielded the largest difference in AF/AT recurrence-free survival. Results - Of 3474 patients enrolled in this study, analysis was performed in 1720 patients who consumed alcohol regularly before ablation (64&10 years, male 88%, paroxysmal AF 55.9%, persistent AF 31.6%, longstanding persistent AF 12.5%). Median baseline alcohol consumption was 140g per week (interquartile range [IQR]: 70-280g). Alcohol consumption during 1-year follow-up decreased to a median of 70g (IQR: 13-162g, p<0.0001). Multivariate Cox regression analysis demonstrated that alcohol reduction of ≥1% from baseline to 1-year follow-up (median reduction: 75%, [IQR: 45-100%]) was associated with lower risk of AF/AT recurrence (hazard ratio: 0.630, [95% confidence interval: 0.518-0.768], p <0.001), compared to alcohol reduction of <1% (median: 0%, [IQR: -20%-0%]). Conclusions - This study suggests that abstinence from alcohol improves clinical outcomes of catheter ablation for AF.

Longitudinal risk of death, hospitalizations for atrial fibrillation, and cardiovascular events following catheter ablation of atrial fibrillation: a cohort study

“…Nevertheless, nearly 50% of patients required hospitalization for AF or flutter and repeat ablation, suggesting that additional measures are required to minimize the AF burden. There are several strategies proven to minimize AF recurrence and improve ablation outcomes such as weight loss, 28 reducing alcohol consumption, 29 and optimal management of AF risk factors like comorbid hypertension, diabetes, and sleep apnoea. 30 Systematic implementation of these strategies may further improve ablation outcomes, decrease the disease burden, and reduce the need of hospital admission or repeat procedures.…”

Impact of the COVID-19 Pandemic and Public Restrictions on Outcomes After Catheter Ablation of Atrial Fibrillation

“…The Korean nationwide liquor delivery decreased from 3,841,169 kl in 2019 to 3,611,777 kl in 2020 ( Figure 1D ) ( 11 ). Takahashi et al reported that alcohol reduction was associated with a 37% lower risk of recurrence after AFCA ( 12 ). In particular, the risk almost halved in those with paroxysmal AF ( 12 ).…”

“…Takahashi et al reported that alcohol reduction was associated with a 37% lower risk of recurrence after AFCA ( 12 ). In particular, the risk almost halved in those with paroxysmal AF ( 12 ). The proportion of current drinkers among patients with paroxysmal AF in this study was significantly higher in the pre-COVID-19 era (29.2%) than in the COVID-19 era (19.0%; P = 0.003), whereas there was no significant difference between 34.1% in the pre-COVID-19 era and 29.0% in the COVID-19 era among patients with persistent AF ( P = 0.352).…”

The year in cardiovascular medicine 2021: arrhythmias

“… 3 , 4 Furthermore, abstinence from alcohol after a new diagnosis of AF was associated with a 14% reduction in stroke compared with continued drinking in a population-based study from Korea. 5 So, alcohol and AF seem to have an atypical relationship 6 , 7 vs. other cardiovascular disorders.…”

“… 7 Stopping consuming alcohol after detection of AF may reduce stroke; 5 it may also reduce the recurrence of AF after ablation. 6 Less AF 24 , 25 and stroke 25 was also seen with higher levels of physical activity (PA) as measured by modern day monitoring technology (#) in LOOP trial 24 and UK Biobank. 25 Also from the UK Biobank: long-term night shift work may cause AF.…”