Modest alcohol consumption is associated with significant left atrial conduction slowing.

Abstract

Background: Regular alcohol consumption is associated with left atrial (LA) dilatation and higher atrial fibrillation (AF) risk. Objective(s): To determine the impact of regular alcohol consumption on LA conduction using high-density elec-troanatomic mapping. Method(s): We prospectively enrolled 33 AF patients to undergo high-density LA mapping using a multipolar catheter. Patients were classified as regular drinkers (>7 drinks/week) or minimal/non-drinkers (<7 drinks/week). Isochronal activation maps were created using the Confidense algorithm (CARTO) during CSd pacing at 600ms. The LA was divided into anterior, posterior, septal, lateral and inferior regions. Mean regional conduction velocity (CV) was determined by averaging CVs of 5 regional point pairs, where 'CV = distance between 2 points/A local activation time'. Automated analysis was confirmed with electrogram inspection. 'Low voltage' was defined as <0.5mV. Investigators were blinded to drinking status during EGM analysis. Result(s): High-density LA mapping (mean 1533 +/- 763 points per patient) was performed on 13 regular drinkers (14 +/-4 drinks/week, age 60 +/-7 yrs, paroxysmal AF 6/13, AF duration 44 +/- 53 mths) and 20 minimal/non-drinkers (1+/-2 drinks/week, age 58 +/-8 yrs, paroxysmal AF 8/20, AF duration 66 +/-70 mths). Mean regional CV was significantly slower for regular drinkers (0.82 +/-0.20 m/s, n = 65 regions) vs minimal/non-drinkers (0.94 +/-0.37 m/s, n = 100 regions; P = 0.007). There was no significant difference in mean bipolar LA voltage (drinkers 1.69 +/- 0.66 mV vs non-drinkers 1.72 +/- 0.69 mV; P = 0.91) or % low voltage points per region (drinkers 27 +/- 15% vs non-drinkers 22 +/- 14%; P = 0.10). Conclusion(s): Regular alcohol consumption, even at modest levels results in significant LA conduction slowing without changes in voltage.