Drinking alcohol linked to AF recurrence, not changes in atrial substrate
Alcohol intake was associated with recurrent atrial fibrillation after a single ablation but was not linked to changes in the atrial substrate, researchers reported.
Compared with patients who abstained from drinking, those who had one or more drinks per week had lower rate of successful AF ablation at 1 year; however, the difference was not significant among patients who underwent multiple ablations.
Additionally, there was no difference in presence of a low-voltage zone or slow-conduction zone among patients who drank or abstained, according to data published in the Journal of the American Heart Association.
“In this prospective observational study, alcohol consumption was not associated with changes in atrial substrate as confirmed by high-density mapping. Alcohol consumption was associated with AF recurrence after a single ablation, but AF recurrence after a single or multiple ablations did not have an association with alcohol consumption,” Yuichiro Sagawa, MD, PhD, of the department of cardiology at the Japanese Red Cross Musashino Hospital in Tokyo, and colleagues wrote. “The presence of a low-voltage zone and slow-conduction zone was associated with AF recurrence both after a single and a single or multiple ablations.”
To assess the impact of alcohol intake on left atrial voltage, left atrial conduction velocity and outcomes after AF ablation, researchers enrolled 110 patients with AF who underwent high-density left atrial mapping with a high-density grid multipolar catheter during ablation performed at two hospitals in Japan (mean age, 67 years; 41% women).
Patients were stratified by alcohol intake and either classified as abstainers (< 1 drink per week), mild drinkers (1-7 drinks per week) or moderate-heavy drinkers (> 7 drinks per week).
Researchers identified low-voltage zones in 35% of patients and slow-conduction zone in 49% of patients but saw no difference in the prevalence of either between the three drinking groups.
At 12 months, success with a single ablation was lower in patients who were drinkers compared with abstainers (79.3% vs. 95.9%; P = .013); however, the rate of success was not significantly different between patients who were drinkers and abstainers and who required multiple ablations.
Alcohol intake (P = .02), low-voltage zone (P = .032) and slow-conduction zone (P = .02) were associated with recurrent AF after a single ablation, according to the study.
Researchers noted that only low-voltage zone (P = .023) and slow-conduction zone (P = .024) were associated with recurrence after single or multiple ablations.
“Alcohol consumption generates a short-coupled pulmonary vein trigger in patients with AF, which may lead to an increase in AF initiation. ... If alcohol consumption affects atrial substrate, it is expected to correlate with AF recurrence even after a single or multiple ablations; however, herein, alcohol consumption was not involved in the development of low-voltage zone and slow-conduction zone, suggesting that alcohol consumption was not significantly associated with AF recurrence after a single or multiple ablations,” the researchers wrote. “Further studies are needed to confirm whether alcohol consumption increases the incidence of AF derived from triggers.”
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