Is alcohol OK if you haven't had AFIB in years?

So I am not a big drinker at all, but the other night I was out, and wanted to have a White Russian drink. It's been YEARS since I've had any alcohol.

I had my last ablation with Dr. Natale in June 2014, and haven't had Afib at all, since. None. Is it OK to have an occassional alcoholic drink now? As both coffee and alcohol would sometimes make me go into Afib (as well as many other times when neither was involved)...I felt hesitant to try it.

What's the deal on that?

Barb

I had 2 Ablation’s with Dr. Natale. The last was Summer 2016 with LAA isolated. I have been doing really good. Just hate to brag (superstitious) 😂
I drink bourbon 🥃 in moderation. I like 2-3 oz of Makers Mark or a descent bourbon 🥃 on the rocks. I drink fairly often and have had no issues but I am a bourbon man. Now, that’s my experience. I be am not endorsing alcohol 🥃 but it calms me down. I started back in 2018 after 6 years of refraining because of AFIB.

Go right ahead. Your afib has been locked up in a cage that it can't escape. Drinking alcohol in moderation won't change that.

All three Afib episodes involved alcohol over the course of 10 years. I won't touch it now and hadn't been because it screws up my esophagus. However Dec/2021 I went out to a birthday dinner with relatives and drank wine which I rarely did and went into Afib at 9:45pm until 6:30 am when they were able to get it under control. All 3 episodes also involved a bout with IBS. Wondered if anyone else has that issue with Afib. The December episode created involvement with my cardiologist. His PA told me of a study that wine can put you in Afib! (no kidding) SO I am at the beginning of this........

I also won't touch caffeine, melatonin, sleep aids and most recently Ambien! Two nights ago I took that and my heart flopped around like a fish for two hours.

Quote
tobherd
So I am not a big drinker at all, but the other night I was out, and wanted to have a White Russian drink. It's been YEARS since I've had any alcohol.

I had my last ablation with Dr. Natale in June 2014, and haven't had Afib at all, since. None. Is it OK to have an occassional alcoholic drink now? As both coffee and alcohol would sometimes make me go into Afib (as well as many other times when neither was involved)...I felt hesitant to try it.

What's the deal on that?

Barb

Only you will know.
Only you can say if you really want having a try with alcohol.

I've tried both : without or with (moderately). Didn't make a difference for me. IMO, the crucial aspect is hydration. Good hydration is always essential, and if you drink one or two glasses of beer or wine, staying perfectly hydrated while your body metabolizes your alcohol is the key.
OTOH, if you try alcohol and get quickly afib, you'll know it's definitely bad for you.

I haven’t had a White Russian since 2004. It was my favorite drink but I’m dairy free now so I am not risking afib and a vomit marathon from the cream for a fleeing pleasure of a delicious drink.

Before my first ablation, there were a few occasions where afib followed having two drinks. Maybe a half dozen incidents and over 200 episodes of afib. Coincidence more than likely?

After my first ablation, I had a glass of wine or a beer daily for 13 years and no afib. More than one drink at social events and no afib.

Since my second ablation 2.5 years ago, I have a daily glass of wine and no afib.

Daily morning coffee too, about 12 oz, during the entire period above never caused afib.

Thanks everyone - i would like to feel free to have an occasional drink..and I mean occasional - but will be sure it's a low alcohol option if I do. I have been drinking a couple of cups of coffee for years since my last ablation, without a problem. I do believe my Afib days are OVER. If i didnt have an ablation or certainly a successful one, I wouldn't consider it. But I did - both with Dr. Natale. He also checked my heart while putting in the Watchman this January, and found no issues...no need to do any "touch up" ablating...so I think I'm good.

Always a bit unnerving when you have been an Afibber, isn't it? Probably similar to how someone who's had cancer feels....will it come back?

Thank GOD for Dr. Natale. Happy Monday all ~ Barb

From what I have seen on this website, afib is never "cured", just set aside for some period of time after an ablation and will eventually come back. Without an ablation, there are several things that can be done to help minimize afib episodes, but in most cases, the only real solution is an ablation, with the expectation that afib will be back. I have had two "successful" ablations and it would not surprise me if I have to have a third. Those two ablations have kept me afib free for 15 years and counting. I will drink to that success.

The key issue is moderation, and likely some genetics may be at play here too. Though the following well-done multi-center Randomized Controlled Trial published in 2020 in the New England Journal of Medicine titled: Alcohol Abstinence in Drinkers with Atrial Fibrillation is worth reading.

The key issue here is also use in moderation as those of you above who apparently have successfully engaged in what can be defined as 'moderate' drinking post AFIB, can do so with little consequence. This is a well done, but rather small RCT so keep that in mind as well.

This RCT suggests that sliding too far towards one's 'excess consumption' side, does seem to have negative consequences for an Afibber who has violated their own personal limits of moderation, whatever that may be for the individual. And they do spell out some suggested defining limits of wise alcohol intake per day and week.

Some fairly liberal definitions of moderate drinking are used here (after all, this is an Aussie RCT and as a group their love of a good time is rather legendary :-) ... seriously though, this is an interesting topic that I would guess most all of us have explored to one degree or another during our AFIB careers.

I also know that a number of top centers are doing more of these RCTs in the near future to better flesh out the evidence on this very topic. Which indicates that it's still an open question overall among EPs and Cardios in general ... though any individual Afibber can pretty easily determine which side of the fence they are on, and thus determine just how much any given person can get away with before possible cardio/arrhythmia issues arise ... as more or less suggested by this study.

Cheers!
Shannon


Alcohol Abstinence in Drinkers with Atrial Fibrillation
List of authors.
Aleksandr Voskoboinik, M.B., B.S., Ph.D., Jonathan M. Kalman, M.B., B.S., Ph.D., Anurika De Silva, Ph.D., Thomas Nicholls, M.B., B.S., Benedict Costello, M.B., B.S., Shane Nanayakkara, M.B., B.S., Sandeep Prabhu, M.B., B.S., Ph.D., Dion Stub, M.B., B.S., Ph.D., Sonia Azzopardi, R.N., Donna Vizi, R.N., Geoffrey Wong, M.B., B.S., Chrishan Nalliah, M.B., B.S., et al.
Article
Figures/Media
Metrics

28 References
130 Citing Articles
Letters
Abstract
BACKGROUND
Excessive alcohol consumption is associated with incident atrial fibrillation and adverse atrial remodeling; however, the effect of abstinence from alcohol on secondary prevention of atrial fibrillation is unclear.

METHODS
We conducted a multicenter, prospective, open-label, randomized, controlled trial at six hospitals in Australia. Adults who consumed 10 or more standard drinks (with 1 standard drink containing approximately 12 g of pure alcohol) per week and who had paroxysmal or persistent atrial fibrillation in sinus rhythm at baseline were randomly assigned in a 1:1 ratio to either abstain from alcohol or continue their usual alcohol consumption. The two primary end points were freedom from recurrence of atrial fibrillation (after a 2-week “blanking period”) and total atrial fibrillation burden (proportion of time in atrial fibrillation) during 6 months of follow-up.

RESULTS
Of 140 patients who underwent randomization (85% men; mean [±SD] age, 62±9 years), 70 were assigned to the abstinence group and 70 to the control group. Patients in the abstinence group reduced their alcohol intake from 16.8±7.7 to 2.1±3.7 standard drinks per week (a reduction of 87.5%), and patients in the control group reduced their alcohol intake from 16.4±6.9 to 13.2±6.5 drinks per week (a reduction of 19.5%). After a 2-week blanking period, atrial fibrillation recurred in 37 of 70 patients (53%) in the abstinence group and in 51 of 70 patients (73%) in the control group. The abstinence group had a longer period before recurrence of atrial fibrillation than the control group (hazard ratio, 0.55; 95% confidence interval, 0.36 to 0.84; P=0.005). The atrial fibrillation burden over 6 months of follow-up was significantly lower in the abstinence group than in the control group (median percentage of time in atrial fibrillation, 0.5% [interquartile range, 0.0 to 3.0] vs. 1.2% [interquartile range, 0.0 to 10.3]; P=0.01).

CONCLUSIONS
Abstinence from alcohol reduced arrhythmia recurrences in regular drinkers with atrial fibrillation. (Funded by the Government of Victoria Operational Infrastructure Support Program and others; Australian New Zealand Clinical Trials Registry number, ACTRN12616000256471. opens in new tab.)

Visual Abstract for 'Alcohol Abstinence in Drinkers with Atrial Fibrillation,' A. Voskoboinik and Others (10.1056/NEJMoa1817591)
VISUAL ABSTRACT
Alcohol Abstinence for Atrial Fibrillation



Edited 1 time(s). Last edit at 03/15/2022 03:06PM by Shannon.

Yes indeed Ken, this is a game of buying as much time as possible in good 'ole NSR! All the more reason, in my book, to be discriminating when choosing a highly experienced ablation expert for an ablation.

Shannon

Reading the full paper, they had a hard time finding folks who would agree to the possibility of being assigned to the abstinence group.

They did analyze the af burden during the 4 week "run-in" phase with that after in a post hoc analysis. Unfortunately those data are behind a paywall. As we all have different burden %'s, I think comparing these burdens before the intervention would be very useful.

So if you've had a successful ablation with Dr. Natale, haven't had Afib in over 7 years, no evidence of any Afib or need to do a "touch up" when doing a TEE for the Watchman....are you still considered to be an "Afibber" or a FORMER "Afibber"??

I guess my question is also...if you've had a successful LAA isolation, now have the Watchman, and haven't had Afib in years....what is the likelihood that Afib could rear it's ugly head again? I was thinking it's very low if at all. Am I wrong?

Barb

Quote
tobherd
So if you've had a successful ablation with Dr. Natale, haven't had Afib in over 7 years, no evidence of any Afib or need to do a "touch up" when doing a TEE for the Watchman....are you still considered to be an "Afibber" or a FORMER "Afibber"??

I guess my question is also...if you've had a successful LAA isolation, now have the Watchman, and haven't had Afib in years....what is the likelihood that Afib could rear it's ugly head again? I was thinking it's very low if at all. Am I wrong?

Barb

You're an afibber for life because it's a chronic disease with no known cure.

But you are not wrong, and you wouldn't be wrong even if you'd had only had a standard ablation with no LAA and no Watchman. Read this post. If you've been in NSR for a full year following an ablation without the aid of antiarrhythmic drugs, your ablation was successful and you are very unlikely to ever face afib again.

However, the one thing I left out of that post is that afib is a progressive disease, and so it's possible that years after a successful ablation you could develop new sources of afib that are outside the monkey cage. A few people here have experienced that, going years free of afib after an ablation and then having it reappear. It doesn't reappear because the cage failed or your were doing things that triggered it; it simply progressed to a new location in your heart (ie, you got a second monkey) and now that new monkey needs a new cage. But as I said, that's unlikely to occur.

I am hoping with an "extensive" LAA ablation, that likelihood of ever having another Afib episode is extremely low. Especially since Dr. Natale took another look at my heart during the Watchman implant, - 7.5 years after my last ablation with him, and saw nothing of concern. Apparently I had Afib so much before getting an ablation, that Dr. Natale said two of my veins "self ablated"...he seemed a bit surprised about that, I thought.

Hopefully if we do ever get Afib back, Dr. Natale will still be there to help us once again. But I'm going to go with "I'm done". It's a thing of the past.

Cheers everyone ~ Barb

I’d worry more about the social stigma of ordering anything Russian right now than the potential adverse effects of a tiny amount of alcohol.

Enjoy!

Everyone is different, but after living with afib for over 35 years now, one thing I've learned is....afib + alcohol = bad.