Alcohol Consumption Reduction and Clinical Outcomes of Catheter Ablation for Atrial Fibrillation.

Background - Abstinence from alcohol is effective for reduction of atrial fibrillation (AF) burden. However, effects of alcohol abstinence on clinical outcomes of catheter ablation for AF remain unknown. We sought to assess association of alcohol consumption reduction with clinical outcomes of catheter ablation for AF. Methods - In this multicenter prospective observational study, consecutive patients undergoing catheter ablation for AF were enrolled. All patients were requested to limit alcohol consumption to <20g per week after the ablation. The primary endpoint was AF/atrial tachycardia (AT) recurrence-free survival without antiarrhythmic drugs beyond a 3-month blanking period. Percent reduction of alcohol consumption from baseline to 1-year post-ablation, if freed from AF/AT for 1-year, or to AF/AT recurrence was assessed. Univariate and multivariate Cox regression analyses were performed to assess the association of the percent reduction of alcohol consumption with AF/AT recurrence-free survival as well as to determine the cutoff value for the percent reduction of alcohol consumption that yielded the largest difference in AF/AT recurrence-free survival. Results - Of 3474 patients enrolled in this study, analysis was performed in 1720 patients who consumed alcohol regularly before ablation (64&10 years, male 88%, paroxysmal AF 55.9%, persistent AF 31.6%, longstanding persistent AF 12.5%). Median baseline alcohol consumption was 140g per week (interquartile range [IQR]: 70-280g). Alcohol consumption during 1-year follow-up decreased to a median of 70g (IQR: 13-162g, p<0.0001). Multivariate Cox regression analysis demonstrated that alcohol reduction of ≥1% from baseline to 1-year follow-up (median reduction: 75%, [IQR: 45-100%]) was associated with lower risk of AF/AT recurrence (hazard ratio: 0.630, [95% confidence interval: 0.518-0.768], p <0.001), compared to alcohol reduction of <1% (median: 0%, [IQR: -20%-0%]). Conclusions - This study suggests that abstinence from alcohol improves clinical outcomes of catheter ablation for AF.