Background: Prior observational studies have suggested that a dose-dependent effect may exist between alcohol intake and incident AFib, recurrence after ablation, and cardiac structural changes.
Study design: Prospective, open-label, multicenter, randomized clinical trial, with an intention-to-treat analysis.
Setting: Six tertiary care hospitals in Australia.
Synopsis: Study authors enrolled 140 patients with symptomatic paroxysmal or persistent AFib and regular alcohol consumption of 10 or more standard drinks per week. Participants were randomized to alcohol abstinence or usual alcohol intake. They underwent comprehensive rhythm monitoring and alcohol intake assessment for 6 months with in-person visits and oral/electronic communication. Over the 6-month period, patients in the abstinence group reduced their mean drinks per week from approximately 17 to 2, with 61% achieving complete abstinence. Patients in the abstinence group had a significantly longer period before recurrence of AFib when compared with the control group. Furthermore, the AFib burden over 6 months was significantly lower in the abstinence group, compared with the control group (0.5% vs. 1.2%).
Bottom line: For patients with symptomatic paroxysmal or persistent atrial fibrillation and regular alcohol consumption, reducing alcohol intake may significantly lower AFib burden and increase the time-to-recurrence of AFib at 6 months.
Citation: Voskoboinik A et al. Alcohol abstinence in drinkers with atrial fibrillation. N Engl J Med 2020 Jan 2;382:20-8.
Dr. Cool is a hospitalist at Beth Israel Deaconess Medical Center, and instructor in medicine, Harvard Medical School, both in Boston.