Open AccessImpact of Alcohol Consumption on Substrate Remodeling and Ablation Outcome of Paroxysmal Atrial Fibrillation
Author(s) -
Qiao Yu,
Shi Rui,
Hou Bingbo,
Wu Lingmin,
Zheng Lihui,
Ding Ligang,
Chen Gang,
Zhang Shu,
Yao Yan
Publication year - 2015
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.115.002349
Subject(s) - medicine , atrial fibrillation , cardiology , hazard ratio , confidence interval , odds ratio , sinus rhythm , proportional hazards model , alcohol septal ablation , hypertrophic cardiomyopathy , obstructive cardiomyopathy
Background The effect of alcohol consumption on substrate remodeling and ablation outcome of paroxysmal atrial fibrillation ( PAF ) remains unknown. Methods and Results We performed circumferential pulmonary vein isolation ( CPVI ) and voltage mapping of left atrium ( LA ) during sinus rhythm in 122 consecutive patients with symptomatic PAF (age, 55.4±9.4 years; 73.8% men). Low‐voltage zones ( LVZ s) were semiquantitatively estimated and presented as low‐voltage index ( LVI ). Each patient's daily alcohol consumption history was recorded at baseline and classified into alcohol abstainers, moderate drinkers, and heavy drinkers based on the National Institute on Alcohol Abuse and Alcoholism definition. Follow‐up was ≥12 months for AF recurrence. Alcohol abstainers and moderate and heavy drinkers were 70 (57.4%), 13 (10.6%), and 39 (32.0%), respectively. In total, LVZ s were observed in 44 patients (36.1%). Daily alcohol consumption independently predicted presence of LVZ s (odds ratio [ OR ], 1.097; 95% confidence interval [ CI ], 1.001–1.203; P =0.047). During mean follow‐up of 20.9±5.9 months, 40 patients (35.1%) experienced AF recurrence. Success rate was 81.3%, 69.2%, and 35.1% in alcohol abstainers, moderate drinkers, and heavy drinkers, respectively (overall log rank, P <0.001). Multivariate analysis showed that both alcohol consumption and LVI were independent predictors of AF recurrence (hazard ratio [ HR ], 1.579; 95% CI , 1.085–2.298; P =0.017; HR , 2.188; 95% CI , 1.582–3.026; P <0.001, respectively). Furthermore, mediation analysis revealed that LVZ s acted as a partial mediator in effect of alcohol consumption on AF ablation outcomes. Conclusions Daily alcohol consumption was associated with atrial remodelling, and heavy drinkers have substantial risk for AF recurrence after CPVI .