Wine And A-Fib?

Wondering if anyone has experience with wine/alcohol consumption and onset of A-fib/flutter?

LONG story short, I’ve been a high intensity endurance athlete (cycling) for 20 years. Used to race but not anymore. But still enjoy riding fast in group or solo rides where I push my heart rate to threshold and keep it there for a while. At least I used to until 6 months ago when I started showing symptoms of A-fib. Both at random times AND while pushing my HR up on the bike (flutter).

I’ve also been a regular/daily consumer of wine and beer for 30 ish years. Never to excess but moderate amounts.

I’ve learned that it is becoming common for older (50/60’s) high intensity endurance athletes to develop A-fib. But I’ve also read that alcohol and coffee consumption are risk factors or triggers. So while it could be that my exercising caused the A-fib to start up. But also possibly the alcohol consumption? Anyone have experience or thoughts on this?

My symptoms got bad enough, and weren’t responding too well to medication, that I had an ablation done about 4 weeks ago. So far the A-fib has stopped, so that’s good news, but they say it really takes 3-6 months for the heart to settle down after the procedure to properly evaluate the effectiveness of the procedure.

Thanks, Greg

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Sounds terrible. I hope you’re going to be OK.

And seriously, if I had a problem with a-fib from wine, I’d completely cut out wine. In your case it sounds like you may be having an argument with Father Time, although you say it happens both when you exert yourself and when you don’t.

No advice here but all the best to you with that. It’s scary stuff. Take care.

  • another Greg

Bobby better be careful.

I had catheter ablation for the same thing, but I’d hesitate before offering you much advice. SVTs are like Parkinson’s symptoms – they can mean different things for different people. However I can tell you this, which no one else told me – my symptoms are closely correlated with dehydration. I have only had a couple of episodes since they burned out a little piece of my heart (what a metaphor), but each time it was because I hadn’t had enough water. I now drink 1/2 my body weight in ounces on the days I don’t exercise, and more as needed on the other days, and my symptoms have pretty much vanished. I have a feeling that though there are other ways alcohol and coffe might impact this, the dehydration effect is pretty big.

G

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Another thread

https://www.wineberserkers.com/forum/viewtopic.php?p=2646845#p2646845

In horse racing, we will get the occasional A-Fib. And we always focus on hydration. And before events, they get Calcium and Potassium. Almost all of them are controlled this way. Slow-K is something we give horses and Calcium Gluconate the day before and the day of…although it is not legal the day of to give it, people will if it is that important.

Thanks all!

Interesting about the dehydration angle. I’ve always been guilty of not drinking enough water so I’ve been trying to correct that. I also read about being deficient in potassium and/or magnesium can cause the fib. So I’ve been experimenting with supplementing them.

It is so hard to determine which of the many afib triggers cause an episode but I do believe that dehydration has been associated with most but not all of my episodes.

Wine can definitely trigger a fib. 1-2 glasses is usually ok but some are very sensitive and smaller amounts will trigger it.

Also, good not to have it multiple days running.

Have a friend, (64 yrs old), who has had two catheter ablations. The first one didn’t solve it and so far it appears the second one was successful. I know he doesn’t stay hydrated, drinks a fair amount, mostly Seagrams Seven and wine with some dinners or after our weekly golf outing. He has cut out basketball, but still bowls and golfs.

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Ideally, we’d have echocardiograms at age 21 and then later to track changes in the size of our atriums over time.

Many interesting correlations to A FIB.

https://watermark.silverchair.com/4-1-36.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAkYwggJCBgkqhkiG9w0BBwagggIzMIICLwIBADCCAigGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMnktnwsL4M0yTUEJeAgEQgIIB-b7-Q8NOJINKcb6cwJLTC-iTUuJmH0jxE6BOvkF3LEsnGjYpL9xSWYJX6NjpcclyYbxLovole9WVP9A3pS24QK7E1R6vZbRlZKaxWc4XjbFxbLcYGqGXBT2FgVQXpmEx5pSBE6y56lEkrDOJ7d2BbxsTarwqKWz3CY7wfRLi5Dt9bOlCftX0xAYhGargj6nfoOox_HoqPcNlXR0DHj2UZGoiYW9u1lNhE-QjBWkgGA2l97thXrjsDJEcx_558Va-WFvhYYYKWePwf89ayQlwzYTMJbK7k6HcuVkVaz1xSoEgwkTnckNGbrqSxuU34oP_4whmyq4sKHEGHkYHHv5yGwNynA-wDpgMiegzh3tfozd1b4VS5_CjPJ32BqVyX1Sih1st42Pdb-SnQTjiB2ouk1OiX5CqkSVH2blPOV0agTKEzev6EqDwjhiSmjXmzDvXHaVMN6Ijyzqtq2paepLcfP0bhlXxchHbpqAxm5JQgsN_gHqn3sh1Is_hW6JJ4TpaPu9DPDPBTQu4ScMsVfqGaOPBtu7CvS5qHZfI9xqIIMS4OEa3N9ku6_vA6XJ5ikzTrAc0jIWSTXeqZ1yusW9kgTYH0aFR6SRt6z1fFrK4RBIuFM1u2apV5oWBEN5T19UvD8Wg2SKMRxiZRtfD-vovv5rotL2bKmzIgeU

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Greg–there’s a long history of connection with alcohol consumption and afib. But you are a special case as a high performance athlete, and by bringing on your afib with extreme exertion. As I suspect you are aware, there are things that can happen cardiac-wise in older high performance athletes. I’m a general internist, so can’t really give you high level specialty advice. I would be sure that you are hooked up with a good cardiologist and electrophysiologist, which I’m sure you likely are if you’ve had an ablation. whether alcohol has much to do with your trouble or not is not possible to sort out on a wine board. It might have very little to do with things, or could be a significant trigger.

Clear link between alcohol consumption and Afib. Some studies show even light drinkers have increased risk. Also clear link with endurance athletes and Afib. Atrial flutter is a completely different animal and while it shares some risk factors with Afib (anything that causes atrial remodeling) is treated differently and responds better to ablation. Id talk to you EP about alcohol consumption. He/she may have some recommendations based on your symptoms and the degree of atrial remodeling. They will have your echo data and probably a 3D map from your ablation to inform decisions. Sorry, can’t really generalize as this is a patient level recommendation.
Also consider sleep apnea screening given link with alcohol consumption (even if not overweight)

This one. I will second and third this suggestion!

It is a complex issue. I was diagnosed with afib in Feb 2018. I’ve had two catheter ablations, most recently Mar 11, 2019. I abstained completely from alcohol for a full 3 months after the ablation, which is the duration of a typical post-ablation inflammation recovery period. I’ve also done a great deal of reading from the cardiology research literature and would be glad to send you some papers via private mail. Key points are as follows:

  1. If you limit your alcohol consumption to seven or fewer 12 gm servings per week, your risk of recurrent afib is not significantly different than a non-drinker. Risk of recurrence goes up if you consume more alcohol. At a “moderate” level of more than 8 servings but less than 21 servings, the risk of recurrent afib is around 30-35%. Keep in mind that minimizing risk of afib is important to prevent progression to persistent (essentially continuous) afib.
  2. Twelve grams of alcohol is about 4 ounces of 13.0% abv wine (120 ml x 0.13 = 15.6 ml alcohol; 15.6 x specific gravity of 0.8 = 12.48 gms alcohol).
  3. There is no established safe level of everyday consumption of alcohol at any volume.

The approach I’m taking, also in consultation with my EP cardiologist, is to limit my consumption to 6 ounces on non-consecutive days. Six ounces would be about 18 gms of alcohol, more or less, so about 1.5 servings of alcohol. If I consume 6 oz no more than four times in a week, that would be 6 servings, which keeps me within that 7 servings limit and no consecutive days consumption. Like many here on the board, my previous pattern of wine drinking was to share most or all of a bottle with my wife most days, so this is a new relationship with wine for me. I will simply say this: I found afib to be extremely uncomfortable, stressful, anxiety-provoking, and unacceptable if I have a choice. My episodes were up to 18 hours in duration and had one episode of 6 days. Sometimes I could barely get off the couch. I was instructed to avoid driving when in afib because of near fainting episodes. I’ve been electrically cardioverted and have had two ablations. I’m doing well since the second ablation and still on a rhythm control drug and a blood thinner … no afib, good BP, exercising with no problem, and consuming wine as described. For me, my old pattern of wine consumption is just not worth the risk. Overall health and quality of life is the bottom line. The standard disqualifier is that every patient is a unique individual.

I agree with comments about minimizing risk factors, including an evaluation for sleep apnea.
Best wishes for good recovery following ablation, symptom-free remission, and high quality of life with exercise and healthful wine consumption.

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Glad to hear you’re doing well and thanks for sharing.

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"Also clear link with endurance athletes and Afib. "

Finally, my laziness pays off…normal sinus rhythm baby! [dance-clap.gif]

I hope your procedure was effective.

I read a book almost two years ago titled “The Haywire Heart” that makes a compelling case that too much endurance exercise can lead to arrhythmias, like afib.

https://www.amazon.com/Haywire-Heart-exercise-protect-heart/dp/1937715884/

Mandrola, the author of that book, also believes alcohol consumption is a risk factor for afib, with a linear dose response relationship, though he thinks caffeine doesn’t have the same triggering effect as alcohol.

Some persons can go their whole life drinking prodigious amounts of alcohol and never skip a beat. Others drink only moderately and still end up in the ER waiting for cardioversion. But whatever it is that got one into afib, they say afib begets afib - the heart can start remodeling itself in a way that makes it more prone to arrhythmia.

I think an ablation procedure is like a band aid or suture that, if successful, by stopping in the near term afib episodes, can allow a breathing space for the heart to recover and on its own reverse the electrical remodeling that facilitates the afib. I think whatever factors cause the remodeling do so gradually over a period of time (the biggest overall risk factor for afib is age), so it stands to reason a similar period of time is needed to return the heart to a less afib prone state. But if the same factors that precipitated the afib continue to exist, it’s probably only a matter of time before another ablation would be needed.

After my ablation, and after the washout period, I had no symptoms for close to six years. I got complacent. Then an episode was my wake up call that I shouldn’t take being in sinus rhythm for granted. While wine wasn’t the precipitating factor for that recurrence (it was probably a confluence of stress, not enough sleep, and you guessed it too much exercise on my bike) once that happened I noticed a few days straight of more than two to three glasses of wine would cause me to suffer skipped beats (PACs). I had to learn to pay attention to what my body was telling me and adjust my wine and beer consumption accordingly.

If it were me it would be time to give it up [cheers.gif]

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