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Alcohol consumption and atrial fibrillation/flutter – what is the impact?
Session:
Posters - C. Arrhythmias and Device Therapy
Speaker:
Miguel Espírito Santo
Congress:
CPC 2021
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.9 Atrial Fibrillation - Other
Session Type:
Posters
FP Number:
---
Authors:
Miguel Espírito Santo; Raquel Menezes Fernandes; Teresa Mota; Hugo Costa; Dina Bento; Rui Candeias; Jorge Mimoso; Ilídio Jesus
Abstract
<p><strong><span style="font-size:16px">Alcohol consumption and atrial fibrillation/flutter – what is the impact?</span></strong></p> <p><strong>Introduction</strong>: Alcohol binge, but also modest intake, is associated with increasing risk of atrial fibrillation (AF).</p> <p><strong>Purpose</strong>: To determine the clinical characteristics and prognosis of patients with alcohol consumption and atrial fibrillation or atrial flutter (AFL) submitted to electrical cardioversion (EC).</p> <p><strong>Methods</strong>: We conducted a retrospective study encompassing patients referred to EC due to AF or AFL in our Cardiology Department, from September 2011 to September 2020. Demographic and clinical characteristics, echocardiographic studies and follow-up were analysed. Primary endpoints were the occurrence of ischemic stroke, bleeding complications and all-cause mortality.</p> <p><strong>Results</strong>: A total of 719 patients were referred to EC during the 9-year period, with a median age of 67 years-old, and EC was successfully performed in 93,2%. In this cohort, 20,9% of patients had AFL, 57,3% had arterial hypertension, 34,6% were obese and 6,3% had sleep apnea. 62,1% had persistent AF/AFL, 19,6% presented with first diagnosed AF/AFL and 17,2% was diagnosed with paroxysmal AF/AFL. Left ventricular ejection fraction was preserved in 66,7% of patients. 89,8% were anticoagulated and, of these, 75,7% were medicated with non- vitamin K antagonist oral anticoagulants (NOAC). Ninety six patients (13,3%) mentioned regular or acute alcohol consumption, with a frank male predominance (97,9%) and a younger age (56,15 vs 68,83 years-old; p<;0,001). Only 34% of these patients had AF/AFL lasting less than 48 hours, with 59,4% having persistent AF/AFL. Patients with alcohol consumption had lower values of CHA2DS2-VASc (1,53 vs 2,99; p < 0,001) and HAS-BLED (0,4 vs 0,86; p < 0,001) scores, being also more frequently treated with NOAC (87,3% vs 73,5%; p=0,02). They had more AF/AFL recurrences (0,94 vs 0,63; p=0,021), were more submitted to additional EC (33,3% vs 14,6%; p=0,002) and referred to ablation procedures (23,2% vs 8,8%; p=0,007). No statistically significant differences were found regarding the primary endpoints between the two groups.</p> <p><strong>Conclusion</strong>: Patients with AF/AFL and alcohol consumption are younger, generally male and have lower embolic and bleeding risk (according to CHA2DS2-VASc and HAS-BLED scores). Due to their higher rate of AF/AFL recurrence, they are more submitted to additional EC and<br /> referred to ablation procedures. Alcohol withdrawal is essential for the success of EC and ablation procedures in maintaining sinus rhythm.</p>
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