Abstract 16475: Impact of Alcohol Intake on Outcomes of Atrial Fibrillation Catheter Ablation: A Propensity Score Matched Comparison

Introduction:Chronic Alcohol drinking has been associated with an increased incidence of atrial fibrillation (AF). A relationship between alcohol consumption patterns and development of various electrophysiological abnormalities of cardiac substrate has been reported.Hypothesis:We aimed at elucidating the effect of alcohol intake on the outcomes of AF catheter ablation.Methods:Between January 2014 and January 2018, 2453 patients underwent their first AF catheter ablation at our institution. Alcohol intake was classified as 1-4 drinks/week (light drinkers), 5-7 drinks/week (moderate drinkers), or >7 drinks/week (heavy drinkers). In order to attenuate the observed imbalance in baseline parameters between groups, we performed a 1:3 propensity score (PS) matching with alcohol consumption as dependent variable and baseline and clinical characteristics as covariates. Moderate/severe drinkers (Group1, n=135) were compared with 405 matched non-drinkers or light drinkers (Group2). Matching was performed without replacement and a calliper of 0.002 of the standard deviation.Long-term success was assessed off-antiarrhythmic drugs.Results:The mean age of the population was 64?9 and 83% of patients were males. The ratio of paroxysmal AF was 45%. Matched populations had similar demographic and comorbidity profiles, including hypertension (56%), diabetes (17%), sleep-related breathing disorders (19%), coronary artery disease (21%), and heart failure (14%). Severe left atrial scar was present in 21% of patients in Group1 and 13% in Group2 (p=0.037). After pulmonary vein (PV) isolation and high-dose isoproterenol infusion, triggers from non-PV sites were documented in 67% and 54% of patients in Group1 and 2, respectively. After 21?6 months of follow-up, arrhythmia-free survival was similar between groups (64% vs. 68%; p=0.24).In comparison to Group2, Group1 patients who underwent PV isolation alone without ablation of extra-PV triggers had significantly worse outcomes (44% vs. 63%; p=0.024).Conclusions:In our population, moderate-severe alcohol consumption was associated with structural atrial remodeling and increased incidence of extra-PV triggers. Elimination of those triggers resulted in improved arrhythmia-free survival.