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Canadian Journal of Cardiology

Alcohol Abstinence Around Atrial Fibrillation Ablation: Breaking Common Habits

  • Dominik Linz
    Correspondence
    Corresponding author: Dr Dominik Linz, Maastricht UMC+, Maastricht Heart and Vascular Center, 6202 AZ Maastricht, The Netherlands. Tel.: +31(0)43-3875093
    Affiliations
    Cardiovascular Research Institute Maastricht, Maastricht University, The Netherlands

    Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands

    Centre for Heart Rhythm Disorders, Royal Adelaide Hospital, University of Adelaide, Adelaide, South Australia, Australia

    Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
    Search for articles by this author
  • Sevasti-Maria Chaldoupi
    Affiliations
    Cardiovascular Research Institute Maastricht, Maastricht University, The Netherlands

    Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands

    Centre for Heart Rhythm Disorders, Royal Adelaide Hospital, University of Adelaide, Adelaide, South Australia, Australia

    Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
    Search for articles by this author
Published:January 18, 2023DOI:https://doi.org/10.1016/j.cjca.2023.01.006
      Alcohol consumption is an established risk factor for the development of atrial fibrillation (AF).
      • Linz B.
      • Hertel J.N.
      • Jespersen T.
      • Linz D.
      Mechanisms and therapeutic opportunities in atrial fibrillation in relationship to alcohol use and abuse.
      Three recent meta-analyses suggest a relatively linear relationship between habitual alcohol consumption and new-onset AF, with an increasing AF risk by 8% for each extra alcoholic drink per day,
      • Larsson S.C.
      • Drca N.
      • Wolk A.
      Alcohol consumption and risk of atrial fibrillation a prospective study and dose-response meta-analysis.
      by 8% for every 6 standard drinks/week,
      • Kodama S.
      • Saito K.
      • Tanaka S.
      • et al.
      Alcohol consumption and risk of atrial fibrillation: a meta-analysis.
      and by 17% in women consuming > 14 standard drinks/week or 25% in men consuming > 21 standard drinks/week.
      • Samokhvalov A.V.
      • Irving H.M.
      • Rehm J.
      Alcohol consumption as a risk factor for atrial fibrillation: a systematic review and meta-analysis.
      In addition, 2 recent analyses of large cohorts focused further on the effect of low alcohol consumption on AF risk. In the UK Biobank cohort, a J-shaped relationship for alcohol and AF risk has been observed with the lowest AF risk at approximately 5 standard drinks (35 g alcohol)/week.
      • Tu S.J.
      • Gallagher C.
      • Elliott A.D.
      • et al.
      Risk thresholds for total and beverage-specific alcohol consumption and incident atrial fibrillation.
      Above this amount, AF risk appeared to rise, with a roughly linear 5% increase in risk for every 7 standard drinks (56 g alcohol)/week or 1 standard drink (8 g alcohol)/day. However, these results contrast to a recent report of approximately 100,000 individuals pooled from different European cohorts suggesting a curvilinear relationship and increase in AF risk from very low alcohol levels.
      • Csengeri D.
      • Sprünker N.A.
      • di Castelnuovo A.
      • et al.
      Alcohol consumption, atrial fibrillation, and cardiovascular disease: finding the right balance.
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