how has atrial fibrillation affected your wine activities

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Brian Crabtree
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how has atrial fibrillation affected your wine activities

#1 Post by Brian Crabtree » January 8th, 2019, 5:27 pm

Like many of you, wine and activities around wine have been a hobby for many years which I have shared with my wife. We have consumed a bottle together most days, vacation travel has been to France (especially Burgundy), Germany, Italy, Austria, and California wine regions. The owners of the gite where we stay in Magny-les-Villers have become friends. We've picked cherries from their tree in the back yard, sat in their living room, watched their grandkids grow. Even their dogs know us. We exchange emails through the year. Our wine hobby has been our entry into exploring food, cheese, coffee at a deeper level. We've attended many events with friends, hosted events in our home, take special bottles to special dinner occasions. Sound familiar? Now I have atrial fibrillation for approaching one year, on medication (failed one, now on the second, plus a blood thinner), ablated once, and still with occasional runs of AF. I've limited wine to 0.75-1.5 glasses, 4-9 oz, most days. Now I'm abstaining until I get a firm idea of what influence, if any, the wine has. Clearly, all the literature says even moderate consumption on a daily basis can have an effect. My electrophysiologist/cardiologist says to keep it to a glass a day of about 5 or 6 oz. Honestly, it has taken much of the pleasure out of wine and has affected our lifestyle. Even when consuming, I don't fully enjoy it because I wonder if I'm setting myself up for another episode of AF. Last week, I opened a 1995 Bouchard Beaune Greves Vigne de L'Enfant Jesus. It was sublime and I made that glass or so last as long as I could, but things are not the same.

So, for you other oldsters (or youngsters if you have this problem, sorry) with AF, how has it affected you and how have you adapted your hobby, your attitude, your outlook? I may be facing a repeat ablation and maybe that will provide better control. Or maybe I'll learn to live with it and minimize risks through lifestyle modification, including abstention from wine and caffeine (already switched to decaf). It's a first-world problem, I know, and I know there are many, many people with health problems and other problems much greater than this. I'm truly grateful for my blessings and place in life. Nonetheless, I'm feeling a bit of a loss right now. For the moment, I need to stay in the moment and not project too much into the future, but I would appreciate hearing about the experiences of others.

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Re: how has atrial fibrillation affected your wine activities

#2 Post by Howard Cooper » January 8th, 2019, 5:33 pm

I am sorry about your health issues. I don't have AF so I cannot help you, but clearly with age there are things I cannot do that I used to be able to do (and miss) AND many areas that are better than ever (including tremendous stress reduction). Hope you stay in good health.
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Re: how has atrial fibrillation affected your wine activities

#3 Post by Wes Barton » January 8th, 2019, 6:07 pm

Nursing a glass is one strategy, but you might find it more satisfying to use a spit cup, so you can take bigger sips and more often, then just spit most or all of it. Several of my wine friends have had to switch to entirely spitting due to health reasons, so they could keep up the hobby and keep attending big wine dinners and such. As a professional I'm exclusively spitting most of the time. That extends to tastings and OLs - want to assess the wines properly, and then drive, so I stay sober. Not an issue for me in the least. It's habit.
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Re: how has atrial fibrillation affected your wine activities

#4 Post by D@vid Bu3ker » January 8th, 2019, 6:13 pm

My dad suffers from bouts of a-fib, and alcohol has zero influence on his. His doctor says while it can have an effect, it’s actually rare, but the standard is to tell people to limit/avoid alcohol, because they can’t just say “bottoms up!”
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Re: how has atrial fibrillation affected your wine activities

#5 Post by David_K » January 8th, 2019, 6:21 pm

I don't have AF, but I have been on blood thinners for other heart reasons going on nearly 10 years. It hasn't affected me at all and doesn't appear to have any effect on my readings, and I drink wine regularly. Granted, they tell you not to drink to excess (and some literature on blood thinners says not to drink at all), but I have never been someone who drinks more than 1-2 glasses a night, tops. Of course, everyone has different sensitives to blood thinners, and some people have more difficulty getting in range than others.

So basically what I'm saying is -- listen to your doctor, but it is possible to still enjoy wine (if he/she says you can), and you will become more relaxed with time.
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Re: how has atrial fibrillation affected your wine activities

#6 Post by Matthew King » January 8th, 2019, 6:36 pm

Thanks for thoughtful post. Sounds like you are wisely taking a philosophical approach to all this.

I highly recommend you get second and third opinions. I once faced losing one of my favorite passions ... surfing ... because of a herniated disk in my neck. One doctor told me I needed surgery and that I had to hang up the surfboard.

Found another doctor who gave me wise treatment plan five years ago that allowed me to keep doing what I love and no surgery.

Good luck and stay positive.
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Re: how has atrial fibrillation affected your wine activities

#7 Post by Siun o'Connell » January 8th, 2019, 7:21 pm

I don't have af but did have a "widow maker" heart attack eight years ago (or should I say widower maker?) A few thoughts ... I was told not to drink but after a few months when I asked my cardiac care team, they said the "don't drink" advice was because they worry that people on blood thinners will get drunk, fall and hit their heads - or something similar which is a way bigger risk on blood thinners. Their advice to me was simply to make sure I was not drinking so much I could not safely function. Now your situation may be very different and this may not be good advice for you. The suggestion above to get additional opinions makes sense to me - I had three cardiologists before I found one who I clicked with - highly skilled but also highly non-interventionist whenever possible.

The other thing that strikes me in your comments - and maybe not appropriate - is that serious heart disease often (my doc says always) leads to depression. Our awareness of mortality gets a mighty big jolt and anxiety and depression are pretty likely reactions. My docs all recommended taking this seriously and working with a therapist or similar pro to work through these impacts and that really helped as did cardiac rehab - for the exercise but more for the support emotionally actually. I was so afraid it was happening again - and it sounds like you are having some similar worries that you are going to have another bout of afib ... it took me a few years, way more than one year, to get beyond the continuous anxiety and the resulting depression. It still hits at times ... but it's so much better now.

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Re: how has atrial fibrillation affected your wine activities

#8 Post by julianseersmartin » January 8th, 2019, 8:05 pm

I think it would be fairly obvious if AF was triggered or exacerbated by alcohol consumption. I have a congenital heart disease so AF is the least of my troubles but I do experience it occasionally. Only extremely excessive consumption over multiple days seems to outwardly affect my heart but of course my situation is very different.

Nevertheless I'd be looking at total abstinence for a period of time (months rather than weeks) to either rule alcohol in or out. Obviously you don't consume enough for you to be dependent or anything like that so I would expect the outcome to be in your favour.

Before my next point - do you know the cause? Do you have known node issues or is this something being ascribed to age and "it happens"? Assuming you don't have node issues or something like that read on, if not ignore my next sentence.

AF is one of those things that's massively influenced by general body health, and very commonly sleep apnea, the former often being a cause of the latter. I have no idea how your general health is but that could be a key to reducing AF episodes - by that I mean healthy BMI and a moderate level of fitness.

Another topic is how you deliver moderation. You say you're going for a glass a night - in practice this I doubt this is much different to a bottle between you and your partner once a week. Assuming you aren't getting blotto weekly, I think that may potentially be a better way to enjoy wine as you can spend more time with a particular bottle and get to know it properly.

Were you given a pacemaker after the ablation?

Finally - there is a point where excluding parts of your life makes the rest utterly boring. Weighing up the impact on lifestyle vs the upsides is a rational thing to do, and something you should consider even if it carries risks. Involve your cardiologist in that discussion, and probably the people important to you (and you to them), too.

I speak in depth and frankly with my cardiologist about how to deal with living with these conditions, and the science around the advice she gives me. Those conversations have alleviated many of my fears and allowed me to pursue things like wine safe in the knowledge that the impact may increase risk by x%, which was a totally acceptable figure to me.

Again, I emphasize that my situation is very different, but I hope I've given you some other things to think about and consider. Siun makes a very good point about taking care of your mental health too.

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Re: how has atrial fibrillation affected your wine activities

#9 Post by Barry L i p t o n » January 8th, 2019, 8:18 pm

D@vid Bu3ker wrote:
January 8th, 2019, 6:13 pm
My dad suffers from bouts of a-fib, and alcohol has zero influence on his. His doctor says while it can have an effect, it’s actually rare, but the standard is to tell people to limit/avoid alcohol, because they can’t just say “bottoms up!”
I don’t think that’s true, consuming large amounts of alcohol frequently can impact again in those that have it.

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Re: how has atrial fibrillation affected your wine activities

#10 Post by J.Durham » January 8th, 2019, 8:30 pm

I’d stick with spitting or using coravin (despite its warts) so you can still enjoy the exceptional bottles.
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Re: how has atrial fibrillation affected your wine activities

#11 Post by john stimson » January 8th, 2019, 8:37 pm

Paroxysmal atrial fib and it's interaction with alcohol can be a real problem for wine lovers. Contrary to what has been said above by some posters, there are some patients who are exquisitely sensitive to the effects of alcohol. I have patients who will reproducibly pop into afib with 1/4 glass of wine. Others are less sensitive.

If you have chronic afib, you are in a better space as you are already out of rhythm, so your wine intake will not matter unless you are drinking so much that your ventricular function is affected. If you don't notice when you are in or out of afib and are anti-coagulated, then again it doesn't matter much.

However, if you have episodic afib, especially if your cardiac output falls substantially when you pop into atrial fib, then it's a problem.

So, Brian, I don't have much to offer as advice. If you are already anticoagulated, and don't have significant problems when you pop into afib, then it doesn't matter that much. However, if as is the case with some folks, you lose a lot when you are out of rhythm, then it is more difficult. Basically you can experiment and see how much you can get away with, then limit to a little less than that amount.

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Re: how has atrial fibrillation affected your wine activities

#12 Post by Mark Anisman » January 8th, 2019, 8:54 pm

The other issue is a slight increase in stomach ulcers from the alcohol, and that can cause a significant bleeding event. I surmise the more alcohol you imbibe, the higher the chance of a bleed. you already have an increase incidence of bleeding from the anticoagulation, thus you have added on another risk factor.

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Re: how has atrial fibrillation affected your wine activities

#13 Post by Gary York » January 8th, 2019, 9:08 pm

I have a friend going through this problem right now. In fact he is in line to be considered for a transplant. Other option is the LVAD. Multiple ablations and dobutamine have helped but the gains are small and relatively short lived. Moderate consumption of Alcohol is not the direct problem. Although the fatigue and shortness of breath may remove the pleasure of drinking wine. Decreased liver and kidney function from the cardiac issues, coupled with the consumption of alcohol can lead to problems.
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Re: how has atrial fibrillation affected your wine activities

#14 Post by john stimson » January 8th, 2019, 9:15 pm

Gary--that's about 3 stages of degrees beyond what Brian is talking about. If you have ventricular function problems or chf/cardiomyopathy, that's a far, far more serious issue likely requiring abstinence.

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Re: how has atrial fibrillation affected your wine activities

#15 Post by Maxwell A. » January 8th, 2019, 10:25 pm

Brian, sorry to hear about your current struggles with AF. I had my first experience with AF when I was 20 (I'm 27 now). I ended up having a chemical cardioversion later that day. I don't have anything structurally wrong with my heart but I've had bouts of AF since, about every 1-2 years, usually lasting 1-2 days before going back into rhythm (either naturally or from beta-blockers - no cardioversions since, thankfully). It seems to be just an electrical issue for me and usually happens when I'm stressed and maybe getting less sleep or dehydrated. So do you have a clear structural issue with your heart or is it just electrical misfiring for you?

For what it's worth, I haven't found alcohol consumption to be a factor with triggering AF for me. If it is, it's very insignificant. It seems to only be triggered when a number of things aren't going well for me health-wise, although it has seemed random sometimes too. Of course we are all different, but either way, I'm interested in hearing how things go for you as you try to figure out if wine is playing a part in triggering your AF or not.

I very much hope you are still able to keep wine a sufficiently satisfactory part of your life. Best of luck to you!
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Re: how has atrial fibrillation affected your wine activities

#16 Post by Chris Seiber » January 8th, 2019, 10:52 pm

Great discussion.

Speaking very broadly, there can be an understandable tendency for doctors to give out highly conservative advice, and like all things in life, each of us has to make his own calculus about risk and benefit. We do it every day without even thinking about it — driving a car, riding a bike, eating and drinking, outdoors activities, etc.

I’m not saying to ignore all medical advice and indulge yourself, but also don’t feel like a doctor’s recommendation is the end of the question. Understand the risk as best you can, and then make your own decision about how that weighs against the benefits to you, which in this instance are quite considerable.

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Re: how has atrial fibrillation affected your wine activities

#17 Post by Barry L i p t o n » January 9th, 2019, 2:04 am

The benefits of wine pale compared to the benefits of health.

There is a tendency in this board to overplay one and downplay medical advice.

John S’s advice was excellent.

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Re: how has atrial fibrillation affected your wine activities

#18 Post by alan weinberg » January 9th, 2019, 7:45 am

why not a repeat ablation?

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Re: how has atrial fibrillation affected your wine activities

#19 Post by GregT » January 9th, 2019, 8:33 am

Brian - sorry to hear about your problem. No advice here, just noting that you got a lot of advice that's all over the place and I'd get a few professional opinions based on your specific case. Spitting is probably an option, but that's a completely different experience than sitting back at the end of the day with a glass. You really have to decide what's important in your life and act accordingly, with as much knowledge of the potential risks as you can gather, still knowing that nobody can predict the future.

All the best to you whatever you do!
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Re: how has atrial fibrillation affected your wine activities

#20 Post by Anton D » January 9th, 2019, 9:15 am

john stimson wrote:
January 8th, 2019, 8:37 pm
Paroxysmal atrial fib and it's interaction with alcohol can be a real problem for wine lovers. Contrary to what has been said above by some posters, there are some patients who are exquisitely sensitive to the effects of alcohol. I have patients who will reproducibly pop into afib with 1/4 glass of wine. Others are less sensitive.

If you have chronic afib, you are in a better space as you are already out of rhythm, so your wine intake will not matter unless you are drinking so much that your ventricular function is affected. If you don't notice when you are in or out of afib and are anti-coagulated, then again it doesn't matter much.

However, if you have episodic afib, especially if your cardiac output falls substantially when you pop into atrial fib, then it's a problem.

So, Brian, I don't have much to offer as advice. If you are already anticoagulated, and don't have significant problems when you pop into afib, then it doesn't matter that much. However, if as is the case with some folks, you lose a lot when you are out of rhythm, then it is more difficult. Basically you can experiment and see how much you can get away with, then limit to a little less than that amount.
Exactly.

My wife in an chronic intermittent a-fibber and wine/alcohol has no correlation to her course, so she got lucky there. (Interestingly, she is likely one of the alendronate fibbers, but it's a complex stew of cause/effect.)

What John said about experimenting to find your specific niche is the best take.
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Re: how has atrial fibrillation affected your wine activities

#21 Post by Brian Crabtree » January 9th, 2019, 2:36 pm

Wow, thanks, everybody for the comments and perspectives. John, a bit more history. It's paroxysmal, not continuous, definitely influenced by stressful life circumstances and I've induced it a couple of times with vigorous exercise so I'm careful with that, but the relationship to alcohol is unclear. I'll abstain for a hiatus and see how things go. I'm the last in my family to get it. My three sibs all have it and my mother had it. A repeat ablation is a possibility and I know that approach is not unusual, but it is not a pleasant step to contemplate, based on the recovery from the previous procedure. We'll see what the coming weeks bring and perhaps I'll provide an update. Thanks again, everybody.

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Re: how has atrial fibrillation affected your wine activities

#22 Post by dsimmons » January 10th, 2019, 11:39 am

Brian,

I too suffered from AF for several years. During this time I was never able to identify a specific trigger except fatigue. I am fairly certain alcohol was not a trigger.

I had an ablation about a year ago and have not had AF since. My experience with the ablation procedure was dramatically different from yours. The after effects were very mild and limited to a few days of minor discomfort. I am not a Doctor so I am not familiar with different presentations of AF but my Doctor was pretty accurate in his description of what to expect. My recollection is that he said the first ablation is about 80% effective and that a second ablation increases that to 95% +

Best of luck resolving this.
D o n

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Re: how has atrial fibrillation affected your wine activities

#23 Post by Bdklein » January 10th, 2019, 12:24 pm

Here's some info that may help. Recent article

Says alcohol has an effect .

https://www.eurekalert.org/pub_releases ... 010819.php
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Re: how has atrial fibrillation affected your wine activities

#24 Post by Anton D » January 10th, 2019, 12:42 pm

Bdklein wrote:
January 10th, 2019, 12:24 pm
Here's some info that may help. Recent article

Says alcohol has an effect .

https://www.eurekalert.org/pub_releases ... 010819.php
Damn stats!

People who drink alcohol also more commonly die of cirrhosis, car crashes, etc...yet we persist, why? [cheers.gif] This meant in a good way, not being internet trollish.

Could we agree on "alcohol could have an effect on a certain percentage of people?"

Keep in mid, 80% of smokers don't die from smoking related problems, yet we say smoking is bad...all relative risk.

More A Fib stuff...

http://citeseerx.ist.psu.edu/viewdoc/do ... 1&type=pdf

https://www.sciencedirect.com/science/a ... 4903017090

Risk factors are statistical, but not specific to any given individual.

Web MD had a decent normal civilian take: https://www.webmd.com/heart-disease/atr ... on-alcohol
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Re: how has atrial fibrillation affected your wine activities

#25 Post by Joseph MR » January 12th, 2019, 10:55 am

There is a link between atrial fibrillation and sleep
apnea, this should also be considered as potentially an aggravating factor.
ra + * ter

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Re: how has atrial fibrillation affected your wine activities

#26 Post by Brian Crabtree » January 26th, 2019, 6:53 am

Update:
Abstaining from wine consumption made no difference whatsoever. Opened a 2006 Domaine Collotte Marsannay Le Clos de Jue couple of nights ago … lovely with grilled salmon. Repeat ablation scheduled for Mar 11. I'm resolved to the necessity. Hoping this one does the trick.

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Re: how has atrial fibrillation affected your wine activities

#27 Post by Dennis Borczon » January 26th, 2019, 9:21 am

Great discussion here everyone! I have had intermittent afib since I was about 30. Went through an ablation and on med to modify BP. I too have found that limiting the total amount of alcohol makes a big difference in controlling rhythm. Regular exercise, and completely cutting out caffeine helped a lot (I am exquisitely sensitive to any caffeine). General level of stress, physical exercise, and modest alcohol use is absolutely helpful in controlling symptoms. I guess in reality it just really sucks to get older. Good news is that with slow aging of wines in the cellar, you can savor the bottles over time and keep a clear head. I found that limiting myself to only rare overindulgence helps a lot.

Coravin, with all the limitations, is still your friend. This is one of the threads that is priceless here at WB.

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Re: how has atrial fibrillation affected your wine activities

#28 Post by Gerhard P. » January 26th, 2019, 1:40 pm

I´m not having AF, but I´m used to spitting almost any time I´m out of house - and I enjoy it to be able to taste a lot of wine without getting drunk at all.
I can only recommend to get used to spitting as often as possible.
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