The role of alcohol consumption on echocardiographic and electrophysiologic changes in atrial fibrillation

Abstract

Background: A wealth of evidence suggests that alcohol consumption is a risk factor for atrial fibrillation (AF); however, the mechanisms underlying this association are unclear. This makes it challenging to develop therapeutic strategies in patients with AF attributed to alcohol consumption. Purpose: To investigate the echocardiographic and electrophysiologic changes caused by alcohol consumption in patients with AF. Methods: The study was registered in Chinese Clinical Trial Registry (Registration number ChiCTR2000041575). Data on 134 consecutive non-valvular AF patients who underwent radiofrequency catheter ablation in our center was collected from April 1, 2019 to June 30, 2020. Patients were divided into no-alcohol (72) and alcohol groups [categorized into light (34), moderate (11) and heavy (17) alcohol consumption]. All patients underwent echocardiographic and electrophysiologic examinations for the assessment of left atrial (LA) strain, inter-atrial conduction, intra-atrial conduction, and atrial effective refractory period (ERP).Results: Overall, the mean age was 61 ± 11 years and 87 (65%) were males. Compared with the no-alcohol group, impaired peak LA longitudinal strain, obvious inter-atrial conduction delay and increasing ERP dispersion were observed in the alcohol group.Intra-atrial conduction delay and ERP dispersion increased with increasing amounts of alcohol consumption. Conclusion:Alcohol consumption was associated with substantial abnormal echocardiographic and electrophysiologic changes in AF patients. These changes may contribute to the occurrence and progression of AF attributed to alcohol consumption, which may help in the development of new strategies for the prevention and management of AF. However further investigation is required.

Alcohol and Atrial Fibrillation

“…In a randomized and placebo-controlled study by Marcus et al [25], covering 100 subjects, acute exposure to alcohol reduces atrial effective refractory periods (AERP), particularly in the pulmonary veins, which is substrate for AF. In a study by Sha et al [26], including 134 patients with AF, alcohol causes echocardiographic and electrophysiological changes such as impaired peak left atrial longitudinal strain, obvious inter-atrial conduction delay and increasing ERP dispersion. Intra-atrial conduction delay and ERP dispersion also increased with increasing levels of alcohol consumption [26].…”

“…In a study by Sha et al [26], including 134 patients with AF, alcohol causes echocardiographic and electrophysiological changes such as impaired peak left atrial longitudinal strain, obvious inter-atrial conduction delay and increasing ERP dispersion. Intra-atrial conduction delay and ERP dispersion also increased with increasing levels of alcohol consumption [26]. The most important mechanisms of the influence of alcohol consumption on the pathogenesis of AF are summarized in Fig.…”