Cardiology

Alcohol Abstinence in Drinkers with Atrial Fibrillation

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

Hans Rosenberg
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.

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