Alcohol AF

Trial Details

Impact of Alcohol Abstinence in Moderate Drinkers with Atrial Fibrillation: Results from the Alcohol-AF Randomized Controlled Trial

Key Findings

Moderate alcohol drinkers (≥10 standard drinks/week) with AF who abstained had less recurrent AF, longer AF-free survival and a lower AF burden, as well as lower weight and systolic BP compared to those who continued moderate drinking.

Alcohol AF Trial

Alexandr Voskoboinik, MD provides an overview of the results of Alcohol AF, which tracked the effects of alcohol abstinence in moderate drinkers with atrial fibrillation.


Alcohol AF Data
 AbstinenceNot AbstainingP
AF Burden5.6%8.2%0.016
% Recurrence53%73%0.004

Purpose: To examine the impact of alcohol abstinence on outcomes for atrial fibrillation (AF).

Trial design: 140 patients ages 18-85 who had at least 2 episodes of paroxysmal AF in the last 6 months.

Multi-center, randomized, controlled trial comparing alcohol abstinence for 6 months to patients who continue usual alcohol consumption and are provided with materials about safe levels of drinking and advised to have regular follow-up with their healthcare provider.

Primary endpoints: AF/flutter burden – % of time in AF/flutter; Time to first AF recurrence.

Results: Moderate alcohol drinkers (≥10 standard drinks/week) with AF who abstained had less recurrent AF, longer AF-free survival and a lower AF burden, as well as lower weight and systolic BP compared to those who continued moderate drinking.

Background

This trial examines the impact of alcohol abstinence in moderate drinkers on the recurrence of atrial fibrillation.

Trial design: Multicenter, randomized, open-label, controlled. Comparison of alcohol abstinence for 12 months to patients who continue usual alcohol consumption and are provided with materials about safe levels of drinking and advised to have regular follow-up with their healthcare provider. The abstinence group had one-on-one 15-minute sessions with a specialist physician at 0, 3, 6, 9 and 12 months; compliance determined by use of weekly alcohol consumption diaries, phone calls and random urine testing.

Trial population: n=140. 6 Australian hospitals. Patients between the ages of 18 and 85 years who had a minimum of 2 episodes of paroxysmal AF (atrial fibrillation and/or flutter) in the last 6 months or persistent AF requiring direct cardioversion. Their average alcohol intake was at least 10 standard drinks per week (120 g/week).

Primary endpoints:

  • AF/flutter burden – % of time; assessed by 3-monthly 7-day Holter monitor and symptom review with ECG, loop recorder or dual-chamber pacemaker – intervention to 6 months.
     
  • Freedom from recurrence: Time to first AF recurrence assessed by either Holter monitor, loop recorder, dual-chamber pacemaker, or ECG during symptoms – intervention to 6 months.

Secondary endpoints:

  • AF hospitalization
  • BP change
  • Weight change
  • Change in severity of AF symptoms
  • QOL
  • Remodeling - Left atrial size, LVH, left atrial strain on echo, LVEF, LVEDVI

Results:

Primary endpoints:

  • AF burden: Abstinence mean 5.6% vs control 8.2%; p=0.016
  • Time to recurrence - % recurrence: Abstinence mean 53% vs control 73%; p = 0.004

Secondary endpoints:

  • Symptom severity: Abstinence 10% vs control 32%; p<0.05
  • AF hospitalization:  Abstinence 9% vs control 20%; p=0.053
  • Remodeling - LVEF:  Abstinence p=0.30 vs control p=0.39
  • Mean BP change:  Abstinence p=<0.001 vs control p=0.48
  • Weight change:  Abstinence p<0.001; control p=0.03

Sponsors and collaborators: self-funded/unfunded

  • Prof Peter Kistler, Heart Centre, Alfred Hospital, Commercial Rd, Prahran, Victoria, Australia
  • Dr Aleksandr Voskoboinik, Heart Centre, Alfred Hospital, Commercial Rd, Prahran, Victoria, Australia

Key Words
Atrial fibrillation, Atrial flutter, Alcohol abuse, Cardiomyopathy, Hypertension, Obstructive sleep apnoea

Related Clinical Topics
Behavior, AF, prevention, stroke

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