TY - JOUR
T1 - Alcohol Abstinence in Drinkers with Atrial Fibrillation
AU - Voskoboinik, Aleksandr
AU - Kalman, Jonathan M.
AU - Silva, Anurika De
AU - Nicholls, Thomas
AU - Costello, Benedict
AU - Nanayakkara, Shane
AU - Prabhu, Sandeep
AU - Stub, Dion
AU - Azzopardi, Sonia
AU - Vizi, Donna
AU - Wong, Geoffrey
AU - Nalliah, Chrishan
AU - Sugumar, Hariharan
AU - Wong, Michael
AU - Kotschet, Emily
AU - Kaye, David
AU - Taylor, Andrew J.
AU - Kistler, Peter M.
N1 - Funding Information:
Supported in part by the Government of Victoria Operational Infrastructure Support Program. Dr. Voskoboinik is the recipient of postgraduate scholarships cofunded by the National Health and Medical Research Council (NHMRC) and National Heart Foundation and Baker Institute Bright Sparks scholarships; Dr. Kalman, a NHMRC practitioner fellowship; and Dr. Stub, a National Heart Foundation Early Career Fellowship and Viertel Foundation Award. Alive Technologies provided a 20% discount for AliveCor Kardia Mobile EKG monitors.
Publisher Copyright:
© 2020 Massachusetts Medical Society.
PY - 2020/1/2
Y1 - 2020/1/2
N2 - BACKGROUND Excessive alcohol consumption is associated with incident atrial fibrillation and adverse atrial remodeling; however, the effect of abstinence from alcohol on secondary prevention of atrial fibrillation is unclear. METHODS We conducted 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 end points 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. RESULTS Of 140 patients who underwent randomization (85% men; mean [±SD] age, 62±9 years), 70 were assigned to the abstinence group and 70 to the control group. Patients in the abstinence group reduced their alcohol intake from 16.8±7.7 to 2.1±3.7 standard drinks per week (a reduction of 87.5%), and patients in the control group reduced their alcohol intake from 16.4±6.9 to 13.2±6.5 drinks per week (a reduction of 19.5%). After a 2-week blanking period, atrial fibrillation recurred in 37 of 70 patients (53%) in the abstinence group and in 51 of 70 patients (73%) in the control group. The abstinence group had a longer period before recurrence of atrial fibrillation than the control group (hazard ratio, 0.55; 95% confidence interval, 0.36 to 0.84; P = 0.005). The atrial fibrillation burden over 6 months of follow-up was significantly lower in the abstinence group than in the control group (median percentage of time in atrial fibrillation, 0.5% [interquartile range, 0.0 to 3.0] vs. 1.2% [interquartile range, 0.0 to 10.3]; P = 0.01). CONCLUSIONS Abstinence from alcohol reduced arrhythmia recurrences in regular drinkers with atrial fibrillation. (Funded by the Government of Victoria Operational Infrastructure Support Program and others; Australian New Zealand Clinical Trials Registry number, ACTRN12616000256471.).
AB - BACKGROUND Excessive alcohol consumption is associated with incident atrial fibrillation and adverse atrial remodeling; however, the effect of abstinence from alcohol on secondary prevention of atrial fibrillation is unclear. METHODS We conducted 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 end points 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. RESULTS Of 140 patients who underwent randomization (85% men; mean [±SD] age, 62±9 years), 70 were assigned to the abstinence group and 70 to the control group. Patients in the abstinence group reduced their alcohol intake from 16.8±7.7 to 2.1±3.7 standard drinks per week (a reduction of 87.5%), and patients in the control group reduced their alcohol intake from 16.4±6.9 to 13.2±6.5 drinks per week (a reduction of 19.5%). After a 2-week blanking period, atrial fibrillation recurred in 37 of 70 patients (53%) in the abstinence group and in 51 of 70 patients (73%) in the control group. The abstinence group had a longer period before recurrence of atrial fibrillation than the control group (hazard ratio, 0.55; 95% confidence interval, 0.36 to 0.84; P = 0.005). The atrial fibrillation burden over 6 months of follow-up was significantly lower in the abstinence group than in the control group (median percentage of time in atrial fibrillation, 0.5% [interquartile range, 0.0 to 3.0] vs. 1.2% [interquartile range, 0.0 to 10.3]; P = 0.01). CONCLUSIONS Abstinence from alcohol reduced arrhythmia recurrences in regular drinkers with atrial fibrillation. (Funded by the Government of Victoria Operational Infrastructure Support Program and others; Australian New Zealand Clinical Trials Registry number, ACTRN12616000256471.).
UR - http://www.scopus.com/inward/record.url?scp=85077192156&partnerID=8YFLogxK
U2 - 10.1056/NEJMoa1817591
DO - 10.1056/NEJMoa1817591
M3 - Article
C2 - 31893513
AN - SCOPUS:85077192156
SN - 0028-4793
VL - 382
SP - 20
EP - 28
JO - The New England Journal of Medicine
JF - The New England Journal of Medicine
IS - 1
ER -