Alcohol Abstinence in Drinkers with Atrial Fibrillation
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. We conducted a multicenter, prospective, open-label, randomized, controlled trial at...
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| Veröffentlicht in: | The New England journal of medicine 2020-01, Vol.382 (1), p.20 |
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| creator | Voskoboinik, Aleksandr Kalman, Jonathan M De Silva, Anurika Nicholls, Thomas Costello, Benedict Nanayakkara, Shane Prabhu, Sandeep Stub, Dion Azzopardi, Sonia Vizi, Donna Wong, Geoffrey Nalliah, Chrishan Sugumar, Hariharan Wong, Michael Kotschet, Emily Kaye, David Taylor, Andrew J Kistler, Peter M |
| description | 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.
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.
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).
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.). |
| doi_str_mv | 10.1056/NEJMoa1817591 |
| format | Article |
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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.
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).
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.).</description><identifier>EISSN: 1533-4406</identifier><identifier>DOI: 10.1056/NEJMoa1817591</identifier><identifier>PMID: 31893513</identifier><language>eng</language><publisher>United States</publisher><subject>Aged ; Alcohol Abstinence ; Alcohol Drinking - adverse effects ; Atrial Fibrillation - etiology ; Atrial Fibrillation - prevention & control ; Australia ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prospective Studies ; Risk Factors ; Secondary Prevention</subject><ispartof>The New England journal of medicine, 2020-01, Vol.382 (1), p.20</ispartof><rights>Copyright © 2020 Massachusetts Medical Society.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0001-6990-302X ; 0000-0003-2236-0413</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,27907,27908</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31893513$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Voskoboinik, Aleksandr</creatorcontrib><creatorcontrib>Kalman, Jonathan M</creatorcontrib><creatorcontrib>De Silva, Anurika</creatorcontrib><creatorcontrib>Nicholls, Thomas</creatorcontrib><creatorcontrib>Costello, Benedict</creatorcontrib><creatorcontrib>Nanayakkara, Shane</creatorcontrib><creatorcontrib>Prabhu, Sandeep</creatorcontrib><creatorcontrib>Stub, Dion</creatorcontrib><creatorcontrib>Azzopardi, Sonia</creatorcontrib><creatorcontrib>Vizi, Donna</creatorcontrib><creatorcontrib>Wong, Geoffrey</creatorcontrib><creatorcontrib>Nalliah, Chrishan</creatorcontrib><creatorcontrib>Sugumar, Hariharan</creatorcontrib><creatorcontrib>Wong, Michael</creatorcontrib><creatorcontrib>Kotschet, Emily</creatorcontrib><creatorcontrib>Kaye, David</creatorcontrib><creatorcontrib>Taylor, Andrew J</creatorcontrib><creatorcontrib>Kistler, Peter M</creatorcontrib><title>Alcohol Abstinence in Drinkers with Atrial Fibrillation</title><title>The New England journal of medicine</title><addtitle>N Engl J Med</addtitle><description>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.
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.
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).
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.).</description><subject>Aged</subject><subject>Alcohol Abstinence</subject><subject>Alcohol Drinking - adverse effects</subject><subject>Atrial Fibrillation - etiology</subject><subject>Atrial Fibrillation - prevention & control</subject><subject>Australia</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Secondary Prevention</subject><issn>1533-4406</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1j71OwzAURi0kREthZEV-gYBvbMfXY1TaAiqwwFz5L6rBdSInCPH2VAK-4ZztSB8hV8BugMnm9nn1-NQbQFBSwwmZg-S8EoI1M3I-ju_sOBD6jMw4oOYS-JyoNrl-3yfa2nGKOWQXaMz0rsT8EcpIv-K0p-1Uokl0HW2JKZkp9vmCnHYmjeHyzwvytl69Lu-r7cvmYdluqwEYTlVdW8EAhK-x6TxoC6JjzmphtIBOoQwMUaCyzntlbeNBBqMRLTpRH8kX5Pq3O3zaQ_C7ocSDKd-7_wf8BxUtRYc</recordid><startdate>20200102</startdate><enddate>20200102</enddate><creator>Voskoboinik, Aleksandr</creator><creator>Kalman, Jonathan M</creator><creator>De Silva, Anurika</creator><creator>Nicholls, Thomas</creator><creator>Costello, Benedict</creator><creator>Nanayakkara, Shane</creator><creator>Prabhu, Sandeep</creator><creator>Stub, Dion</creator><creator>Azzopardi, Sonia</creator><creator>Vizi, Donna</creator><creator>Wong, Geoffrey</creator><creator>Nalliah, Chrishan</creator><creator>Sugumar, Hariharan</creator><creator>Wong, Michael</creator><creator>Kotschet, Emily</creator><creator>Kaye, David</creator><creator>Taylor, Andrew J</creator><creator>Kistler, Peter M</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><orcidid>https://orcid.org/0000-0001-6990-302X</orcidid><orcidid>https://orcid.org/0000-0003-2236-0413</orcidid></search><sort><creationdate>20200102</creationdate><title>Alcohol Abstinence in Drinkers with Atrial Fibrillation</title><author>Voskoboinik, Aleksandr ; 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however, the effect of abstinence from alcohol on secondary prevention of atrial fibrillation is unclear.
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.
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).
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.).</abstract><cop>United States</cop><pmid>31893513</pmid><doi>10.1056/NEJMoa1817591</doi><orcidid>https://orcid.org/0000-0001-6990-302X</orcidid><orcidid>https://orcid.org/0000-0003-2236-0413</orcidid></addata></record> |
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| subjects | Aged Alcohol Abstinence Alcohol Drinking - adverse effects Atrial Fibrillation - etiology Atrial Fibrillation - prevention & control Australia Female Follow-Up Studies Humans Male Middle Aged Prospective Studies Risk Factors Secondary Prevention |
| title | Alcohol Abstinence in Drinkers with Atrial Fibrillation |
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