Methodology: 5/5
Usefulness: 3.5/5

Voskoboinik A, et al. N Engl J Med. 2020 Jan 2;382(1):20-28. 

Editorial: A Sober Reality? Alcohol, Abstinence, and Atrial Fibrillation.

Question/Methods: Among adults who consume ≥10 drinks/week with symptomatic paroxysmal or persistent atrial fibrillation successfully converted to sinus rhythm, investigators conducted a multicentre RCT of control versus alcohol abstinence. Two blinded cardiologists reviewed tracings from intensive outpatient monitoring to adjudicate AFib recurrence.

Findings Abstinence significantly decreased AFib burden and AFib recurrence within 6 months (hazard ratio 0.55, 95% CI 0.36-0.84). At 6 months, NNT = 5.

Limitations: Abstinence group reported an 87.5% decrease in alcohol intake – unclear if complete abstinence versus minimal consumption is ideal.

Interpretation: Reduction in alcohol use should be encouraged to decrease AFib burden and symptomatic episodes.

By: Dr. Michael Wong

Author

  • Dr. Rosenberg is an emergency physician at the Ottawa Hospital, assistant professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.