One way to help relieve atrial fibrillation: stop drinking

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By Serena Gordon
HealthDay Reporter

THURSDAY, January 2, 2020 (HealthDay News) – If you have atrial fibrillation (a-fib), a potentially dangerous irregular heartbeat, quitting alcohol may relieve your symptoms.

That is what happened when the researchers asked people with atrial fibrillation that they normally have approximately two drinks a day to stop drinking. When they compared abstemies with a similar group of people with atrial fibrillation who continued to drink, the researchers found that those who abstained from drinking alcohol delayed their next episode of atrial fibrillation and reduced the total time they spent on atrial fibrillation.

"Regular and / or excessive alcohol consumption may contribute to episodes and symptoms of atrial fibrillation. One trial [period] Withdrawal or significant reduction in alcohol consumption should be considered as a pillar of atrial fibrillation therapy, "said lead study author Dr. Peter Kistler. He is director of cardiac electrophysiology at Alfred Hospital in Melbourne, Australia.

Kistler added that the additional benefits of abstaining from alcohol include weight loss and reduced blood pressure.

The study was published on January 2 in the New England Journal of Medicine.

Atrial fibrillation affects more than 33 million people worldwide, according to the study's supporting information.

Instead of contracting to pump blood and then relax, atrial fibrillation shakes the upper chambers of the heart (the atria). This allows blood to accumulate in the heart, which can cause a blood clot. When the heart pumps again, the clot is pushed into the circulation. If the clot travels to the brain and blocks a blood vessel, it can cause a stroke, according to the American Heart Association.

The author of an accompanying editorial, Dr. Anne Gillis, said there are several ways alcohol is related to atrial fibrillation. In people who have already been diagnosed with the disorder, Gillis said, "alcohol is a potential trigger for atrial fibrillation."

Drinking also seems to be related to the development of the condition in the first place. Gillis explained that alcohol has been associated with changes that occur in the heart, including scars that can affect the electrical activity that controls the heart rhythm.

He noted that alcohol is also associated with a number of conditions related to atrial fibrillation, such as obesity, obstructive sleep apnea and high blood pressure.


Kistler's study included 140 people from Australia (85% men), with an average age of approximately 63 years.

Half were randomly selected to try to abstain from alcohol. The other half (the "control group") were told that they could continue drinking as they had been.

The 70 people in the withdrawal group had been averaging 17 drinks per week. The control group averaged 16 drinks per week at the beginning of the study. Kistler said everyone was classified as moderate drinkers, and none depended on alcohol.

Nearly two-thirds of the withdrawal group was able to avoid alcohol completely during the six-month trial. The other third decreased significantly and the number of weekly drinks was reduced to two or less during the study period.

The control group ended up drinking a little less, with an average of 13 drinks a week during the study.

Leaving alcohol substantially improved the symptoms of a-fib, but did not completely eliminate a-fib. The episodes still occurred in both groups: 53% in the withdrawal group compared with 73% in the control group, the findings showed.

Gillis, a professor of medicine at the University of Calgary, said the sample size was too small to draw definitive conclusions. Still, "the data provides convincing support for solid recommendations for people with atrial fibrillation to significantly reduce or abstain from alcohol," he said.

"We must focus on the aggressive modification of the risk factor with each patient with atrial fibrillation. Modification of the risk factor [such as weight loss, regular exercise, quitting smoking and a reduction in alcohol consumption] it is useful for controlling this arrhythmia and for other types of cardiovascular diseases, "said Gillis.

According to cardiologist Dr. John Osborne, a spokesman for the American Heart Association, "the benefit was quite impressive in people who could abstain from alcohol. It was similar to the effect of the drugs we use to treat atrial fibrillation."

But he noted that the researchers had difficulty getting people to commit to the abstemious lifestyle. If you don't stop drinking completely, you should try to reduce significantly, Osborne advised.

"It costs nothing and led to a substantial reduction in hospitalization rates. People in the withdrawal group also lost an average of 3.8 kilograms [8.4 pounds] in six months, "he said.

Kistler concluded that "we need to convince people with heart rhythm disorders of the potential benefits of alcohol reduction or withdrawal. This is a safer alternative than drug or catheter ablation. [a type of treatment for a-fib]".

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SOURCES: Peter Kistler, M.B.B.S., Ph.D., director, cardiac electrophysiology, Alfred Hospital, Melbourne, Australia; Anne Gillis, M.D., professor, medicine, department of cardiac sciences, University of Calgary, Alberta, Canada; John Osborne, M.D., cardiologist, spokesman for the American Heart Association, director of cardiology, Heart State Cardiology, Dallas; January 2, 2020,New England Journal of Medicine

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