Atrial flutter and alcohol

How alcohol interacts with AFib

Is any amount of alcohol safe for AFib patients?

Wine is known for its heart-healthy antioxidants, a beer with buddies can be a great end to a stressful week, and cocktails will liven up a party. But heart health can begin to suffer when you drink, and rhythm irregularities like AFib generally don’t mix well with alcohol.

There is an undeniable link between alcohol and atrial fibrillation, as this recent study confirms. It seems that even moderate alcohol consumption can trigger AFib symptoms, turn paroxysmal AFib to persistent AFib, and make it more likely that symptoms will recur after a heart operation. Doctors agree that any cardiovascular benefits that come with light drinking don’t extend to AFib patients.

It’s difficult to know how alcohol will affect your symptoms – a lot depends on the amount and frequency of your drinking, as well as your medical history and medication regimen. Should you avoid drinking altogether? Here are some things to consider before you make that call.

Alcohol’s impact on the heart

Although experts are still unsure how exactly alcohol interacts with heart function, there are some theories to explain the negative symptoms like heart palpitations and an erratic heartbeat. One has to do with the vagal nerve: this nerve that runs through the neck seems to respond to alcohol, and the more your drink, the more vagal nerve activity. This spike in vagal nerve response can spark an AFib event.

AFib symptoms can also come on when your fluid levels aren’t optimal, and alcohol can easily lead to such a situation. Since alcohol is a diuretic, it helps your body eliminate more water, and that can leave you dehydrated. At best, dehydration is uncomfortable; at worst, it can stress your organs, deplete your mineral levels, and ultimately trigger AFib.

Just as different medications can interfere with each other, alcohol can interact with the drugs you take to manage your AFib. Vitamin K antagonists like warfarin or acenocoumarol are particularly problematic when they meet alcohol: these blood-thinning medications can increase your risk of bleeding when you drink. Alcohol use can also cause warfarin to build up in the body, which may bring on another set of complications.

What are the guidelines for AFib patients?

Since there seems to be a direct connection between AFib and alcohol, the American Heart Association recommends that if you don’t drink already, don’t start. However, some people may be able to imbibe now and then, as long as their health history and heart symptoms agree with it. The key is to speak with your doctor about any concerns and be honest about your symptoms – this will help determine if you can have a drink or if you’d do better to avoid it altogether.

Finding a balance

Heavy drinking and AFib are a bad combination – three or more drinks a day significantly increases your risk of an episode, and for every drink on top of that, your risk climbs another 8%. If you drink moderately (two drinks a day for men, or one drink a day for women), you might be alright, but your doctor may still suggest you cut down a bit.

If you want to include alcohol in your diet without drastically raising your risk of an AFib reaction, keep these tips in mind:

Take drink-free days. Binge drinking is definitely a bad idea, but even moderate drinking every day could contribute to AFib. Experts recommend taking two or three dry days a week to relieve the stress on your liver and your heart. Is water too boring? Fill a box with a variety of herbal teas and keep it on the counter so there’s a selection of flavors to choose from, which can keep things interesting.

Pay close attention to your numbers. When you live with a heart condition, you need to pay extra close attention to your body. This means not only watching for symptoms, but also checking key levels. Since alcohol increases blood pressure, which can interfere with heart function, commit to using a blood pressure monitor when you have a drink or two. If the numbers are high, that’s a sign to switch to water.

Top up your fluids and minerals. Alcohol encourages your kidneys to draw water from your tissues and pass it out of your body. But you’re losing more than water: important minerals like sodium and potassium, crucial for proper organ function, will drain out, too. Without these electrolytes, heart function will falter, so you’ll want to top your levels up with water and nutritious food. Sports drinks can be helpful, but they can contain a good deal of sugar, so go easy.

Pass on the nightcap. Good sleep directly impacts your stress levels, and the frequency and severity of AFib episodes. It follows that poor sleep can cause health problems, and alcohol can easily disrupt natural sleep patterns. An evening drink can calm you down in the moment, but it will boost your metabolism during the night, while your body tries to process the energy. That could translate into lots of tossing and turning, and more uncomfortable symptoms in the morning.

Moderation is key. Alcohol intake clearly affects your chances of experiencing AFib symptoms, so it makes good sense to take steps to reduce your drinking. Why not take the opportunity to examine your whole diet, and see what else could do with an adjustment? After making a couple of additions or subtractions, you could start to notice some pleasant changes in your energy levels and quality of life in a matter of weeks.

Cutting out alcohol may reduce atrial fibrillation episodes

(Reuters Health) – For people with atrial fibrillation, abstinence from alcohol may make the heart beat better.

FILE PHOTO: Red wine is poured in a glass in a wine shop in Rome, Italy October 15, 2018. REUTERS/Max Rossi

Eliminating most alcohol consumption dramatically cuts the number of episodes of the potentially-deadly heart rhythm disturbance among moderate and heavy drinkers, according to results of a six-month Australian study of 140 volunteers published in The New England Journal of Medicine.

While atrial fibrillation (AF), or Afib, reappeared in 73% of the people who averaged 13 drinks per week, the rate dropped to 53% among patients in the abstinence group – who weren’t supposed to drink at all but, on average, consumed two drinks weekly.

In addition, among the people trying to abstain, it took longer for their next episode of Afib to occur.

“What this study shows is the potential impact of alcohol reduction or abstinence in people with symptomatic heart rhythm problems,” co-author Dr. Peter Kistler of The Alfred Hospital in Melbourne told Reuters Health by phone. People with Afib symptoms who have 10 drinks per week should be advised to abstain or reduce their alcohol use, he said.

“Alcohol is not only a marker of increased risk of AF (as shown before, based on observational studies), but it seems to be also a real risk factor for AF, because if we ‘treat’ (in this case stop taking alcohol), we have a significant reduction in both the AF burden and the recurrence of AF,” Dr. Renato Lopes, a professor of medicine at Duke University Medical Center in Durham, North Carolina, who wasn’t involved in the study, said in an email.

Afib occurs when the upper chambers of the heart beat erratically. It is the most common heart rhythm problem and a leading cause of stroke. In some people, it comes and goes. Symptoms include weakness, shortness of breath and palpitations.

Doctors try to treat it by controlling blood pressure and other factors, but the new study “presents a compelling argument for alcohol abstinence as part of the successful management of atrial fibrillation,” writes Dr. Anne Gillis of the University of Calgary in an editorial accompanying the study. “Nevertheless, the sobering reality is that for many persons with atrial fibrillation, total abstinence from alcohol may be a difficult goal to achieve.”

In fact, the researchers were originally planning to follow patients for 12 months, but they couldn’t find enough volunteers willing to abstain from alcohol for that long.

The findings are not completely surprising. Population-based research had suggested that every drink (12 ounces of beer, 5 ounces of wine or a 1.5 ounce of distilled spirits) increases the risk of atrial fibrillation by 8%. The new randomized trial was designed to be a definitive test.

The Kistler team found it typically took 120 days for Afib to reappear in the non-drinking group versus 87 days in the group that wasn’t instructed to reduce alcohol consumption.

At the six-month mark, the hearts of the drinkers spent 1.2% of the time in Afib versus 0.5% of the time among volunteers assigned to abstinence.

Two thirds of the volunteers were taking antiarrhythmic drugs. The group allowed to continue to drink reduced their alcohol consumption a bit anyway. In the abstinence group, 61% were able to cut out alcohol completely but one quarter of the volunteers couldn’t get their weekly consumption below two drinks per week.

“Those who completely abstained had more benefit or a greater reduction in atrial fibrillation compared to those who reduced their intake but continued to drink,” Kistler noted. “If we had had complete abstinence, I think the difference would have been even greater.”

The non-drinkers also lost an average of 8 pounds more than the drinkers and saw a significant drop in blood pressure.

Doctors often advise patients that having a drink a day can be good for the heart, but that should not apply to Afib patients, Kistler said. Even in patients with heart disease, the new results “still suggest that they reduce their alcohol intake substantially.”

SOURCE: The New England Journal of Medicine, online January 1, 2020.

Our Standards:The Thomson Reuters Trust Principles.

Atrial Fibrillation and Alcohol: Is It Safe to Drink?

Health experts agree that heavy drinking and atrial fibrillation (Afib) don’t mix. That’s because alcohol can trigger symptoms of the condition, such as heart palpitations. But does that mean people with atrial fibrillation shouldn’t drink at all? And how can you determine what’s a safe amount for you? There are no hard-and-fast atrial fibrillation guidelines on how much alcohol is safe to drink.

Research shows that drinking alcohol may put a person at greater risk for developing Afib in the first place. One study, published in 2011 in the Journal of the American College of Cardiology, analyzed data from 14 studies that had investigated the link between developing atrial fibrillation and drinking alcohol. The researchers concluded that avoiding alcohol completely is the best way to avoid the risk of atrial fibrillation.

A Closer Look at Atrial Fibrillation and Alcohol Risk

However, this doesn’t mean a person at risk for atrial fibrillation or who already has the condition can never sip a glass of wine or beer again. “That research may be true, but it seems like an extreme interpretation,” says Smit Vasaiwala, MD, an assistant professor of cardiology at Loyola University Health System in Maywood, Ill. “Moderate use of alcohol has some benefits. For a person without other risk factors for atrial fibrillation, it’s hard to justify advising complete abstinence from drinking alcohol.” Moderate drinking is no more than one drink a day for women and two drinks a day for men, according to the Dietary Guidelines for Americans.

“This is where the big question remains,” Dr. Vasaiwala says. “Everybody agrees that five drinks a day — defined as binge drinking — is too much, but what about five drinks a week?”

Moderate drinking was the focus of a study in the “Canadian Medical Association Journal” (“CMAJ”) in 2012 that looked at the risk for developing atrial fibrillation in people with other risk factors for the condition, which include age and having certain other health conditions such as diabetes, high blood pressure, and heart disease. After analyzing data on more than 30,000 adults, the researchers found that moderate drinking increased the risk for atrial fibrillation by about 14 percent in people older than 55 who had heart disease or diabetes.

The Dangers of Binge Drinking

The “CMAJ” study and others also point to the detriments of binge drinking — a behavior also called “holiday heart syndrome” because of the tendency for people to overindulge on holidays, and because of the effect it can have on the heart. In fact, the “CMAJ” study found that for people with Afib, binge drinking is as harmful to the heart as heavy drinking on a regular basis.

“Binge drinking triggers the nervous system to overstimulate the heart and can lead to atrial fibrillation — this is a well-established risk,” says Davendra Mehta, MD, PhD, a professor of cardiology at the Icahn School of Medicine and the director of cardiac electrophysiology at Mount Sinai St. Luke’s Hospital in New York City. “The atrial fibrillation risk for moderate drinking isn’t as well-known.”

Can You Drink Alcohol If You Have Atrial Fibrillation?

If you already have Afib, the main question is whether alcohol triggers your atrial fibrillation symptoms.

“For some people with Afib, even one drink is too much,” Dr. Mehta says. “They may have one drink in the evening and wake up at night or in the morning with atrial fibrillation symptoms.”

But that doesn’t apply across the board, Vasaiwala says. “We don’t really know why some people with atrial fibrillation can have a few drinks without a problem and some can’t,” he says. “It’s an individual thing. For some people, any alcohol is like turning on an atrial fibrillation switch. They quickly learn to avoid alcohol completely.”

Nonetheless, people with atrial fibrillation or those at risk for it should consider following some general atrial fibrillation guidelines on alcohol consumption:

  • If you have risk factors for atrial fibrillation, moderate drinking may increase your risk. Talk with your doctor about your individual risk factors.
  • If you already have atrial fibrillation and alcohol triggers your symptoms, don’t drink. Your own response to alcohol will determine your safety guidelines.
  • Remember that moderate drinking equals no more than one drink per day for women and no more than two drinks per day for men.
  • Whether you have atrial fibrillation or not, it’s never safe to binge drink.

If you’re struggling to control your alcohol intake, or having problems managing your atrial fibrillation symptoms, talk with your doctor.

Atrial fibrillation: Daily alcoholic drink riskier than binge drinking

A new study suggests that drinking small amounts of alcohol frequently rather than having infrequent bouts of binge drinking is more likely to increase the risk of developing atrial fibrillation (A-fib), a condition in which the heart beats irregularly.

Share on PinterestNew research suggests that drinking daily may harm the heart’s regular rhythm more than binge drinking.

“Recommendations about alcohol consumption have focused on reducing the absolute amount rather than the frequency,” says study author Dr. Jong-Il Choi, a professor in the department of internal medicine at the Korea University College of Medicine in Seoul.

“Our study suggests that drinking less often may also be important to protect against atrial fibrillation,” he adds.

Prof. Choi, who also works at the Korea University Anam Hospital in Seoul, and his colleagues report their findings in a recent EP Europace study paper.

A-fib is the most common form of heart arrhythmia, a condition in which the heart beats too quickly, too slowly, or in an irregular way.

Prof. Choi observes that “atrial fibrillation is a disease with multiple dreadful complications and significantly impaired quality of life.”

The common symptoms of A-fib include an irregular or fast pulse, palpitations, shortness of breath, fatigue, dizziness, and chest pain.

Between 2.7 and 6.1 million people in the United States have A-fib, according to the Centers for Disease Control and Prevention (CDC).

A-fib causes and consequences

It is sometimes difficult to say what causes A-fib. However, it appears that damage to the heart’s electrical system is often to blame. This damage can happen as a result of heart disease or as a complication of heart surgery. Other conditions, such as chronic uncontrolled high blood pressure, can also affect the heart in this way.

One of the main effects of A-fib is that it causes blood to pool in the lower chambers of the heart, which, in turn, increases the likelihood of clotting.

The potential for clotting is the main reason why the risk of stroke is four to five times higher in people with A-fib than in people without the condition.

An earlier pooled analysis of data from several studies had found that the chances of developing A-fib went up in line with increasing alcohol consumption.

Those findings showed that for every 12 grams of alcohol — roughly the amount in a single drink — that a person consumed per week, there was an 8% higher risk of A-fib.

However, that analysis did not clarify whether the total alcohol consumption or the number of drinking episodes had the strongest effect.

Frequent drinking vs. binge drinking

In the new study, Dr. Choi and colleagues compared the effect of frequent drinking with that of binge drinking on the risk of new-onset A-fib.

They analyzed data on 9,776,956 individuals in the Korean National Health Insurance Service database, which holds records on nearly everybody in the Republic of Korea.

None of the individuals in the analysis had A-fib when, as part of a health checkup in 2009, they completed a survey about alcohol intake.

Using the database records, the researchers were able to track these individuals through to 2017 to spot any occurrences of A-fib.

They assessed the effect of weekly alcohol consumption — which they calculated by multiplying the number of drinking sessions per week by the amount of alcohol consumed in each session — on the risk of new-onset A-fib.

Daily consumption riskier than binge drinking

The analysis revealed weekly alcohol intake to be a significant risk factor for new-onset A-fib.

However, the team found that the strongest factor was drinking sessions per week. Having a daily drink of alcohol was associated with a higher risk of A-fib than drinking twice a week, while drinking once a week was less risky.

In contrast, there was no link between consuming a large amount of alcohol in one session, or binge drinking, and new-onset A-fib.

“Drinking small amount of alcohol frequently,” conclude the authors, “may not be a good strategy to prevent new-onset A-fib.”

They note that the association between the number of drinking episodes and A-fib onset held regardless of sex and age.

Speculating on the reason for the link, Prof. Choi suggests that alcohol could trigger an individual episode of A-fib and that if this keeps repeating, it could “lead to overt disease.”

“In addition,” he notes, “drinking can provoke sleep disturbance, which is a known risk factor for .”

‘Reduce frequency and weekly consumption’

When they looked at weekly consumption of alcohol, the researchers saw that their results supported those of other studies.

They saw a 2% rise in the risk of new-onset A-fib for each additional weekly gram of alcohol consumption.

The results also showed what appeared to be a protective effect of mild alcohol intake compared both with no drinking and with moderate and high levels of consumption.

Those who consumed no alcohol or drank moderate or high amounts had elevated risks of new-onset A-fib of 8.6%, 7.7%, and 21.5%, respectively, compared with mild drinkers.

Prof. Choi proposes, however, that this might not be a “true benefit,” but could be due to the “confounding effect of unmeasured variables.” Only further studies can confirm this.

He suggests that alcohol is likely to be the A-fib risk factor that people can alter most easily.

“To prevent new-onset atrial fibrillation, both the frequency and weekly amount of alcohol consumption should be reduced.”

Prof. Jong-Il Choi

By The Recovery Village Editor Camille Renzoni Reviewer Nathan Jakowski Updated on10/09/19

Atrial fibrillation, or AFib, is a heartbeat that is fast and often irregular. While treatable, it is a severe condition because it may lead to complications like blood clots, heart failure, and stroke. Millions of Americans are diagnosed with AFib each year. Given how prevalent AFib is, you may wonder how alcohol affects AFib.

Unfortunately, alcohol is a known cause of AFib. If you have AFib or are concerned about developing it, abstaining from alcohol is a good choice.

Causes of Atrial Fibrillation

Some common causes of AFib include:

  • Alcohol consumption
  • High blood pressure
  • Heart disease or abnormalities
  • Heart attack or heart surgery
  • Overactive thyroid gland
  • Certain medications
  • Old age
  • A family history of AFib

Does Alcohol Cause AFib?

Alcohol consumption is a known cause of AFib. In the short term, alcohol disrupts your natural pacemaker, or the electric circuitry in the heart that keeps a normal, steady heartbeat. Disruption of steady electrical signals in the heart can lead to an irregular and fast heartbeat. Long-term alcohol consumption can lead to structural changes in the heart that also contribute to AFib risk.

The relationship between alcohol and AFib is dose-dependent, which means the more you drink, the higher your risk of developing AFib.

A study found that even moderate consumption of alcohol, or drinking one to three drinks per day, is associated with increased AFib risk. Heavy drinking, or drinking three or more drinks per day, increases the risk even more. Researchers concluded that for each additional drink per day, the risk of AFib goes up 8 percent.

Even if you don’t drink regularly, a binge, defined as five or more drinks in a single occasion, can lead to AFib. You may have heard of holiday heart syndrome, which is a known condition where heartbeat irregularities occur after heavy drinking. One study found that the risk of AFib was 13 percent higher in people who binge drink compared to people who don’t.

Different Types of Alcohol and AFib

It is not well understood whether certain types of alcohol contribute to AFib risk more than others. However, the results of one study where participants self-reported quantity and type of alcohol consumption suggest that beer may not increase AFib risk as much as wine or liquor.

Among study participants who drank more than 14 drinks per week, those who reported drinking only beer had a 6 percent increased risk of getting AFib, compared to a 30 percent increased risk for wine drinkers and 43 percent for liquor drinkers. While wine and liquor certainly appear to contribute to AFib risk, evidence for beer is less clear.

Key Points: Alcohol and AFib

There are several important points to remember about alcohol and AFib, including:

  • AFib is a heart condition defined by a fast and irregular heartbeat
  • AFib can lead to blood clots, stroke, and heart failure
  • Alcohol is a known cause of AFib
  • The more alcohol you drink per day, the higher your risk of developing AFib
  • Binge drinking also increases your risk of developing AFib
  • While liquor and wine appear to increase the risk of AFib, it is not known if beer has the same effect

If you are struggling with alcohol use, help is available. The Recovery Village offers personalized treatment programs to help you or a loved one overcome alcohol abuse and addiction. Call The Recovery Village today to learn more.

  1. U.S. National Library of Medicine. “Atrial fibrillation or flutter.” Medline Plus, 2018. Accessed March 25, 2019.
  2. Rosenthal, Lawrence. “Atrial Fibrillation.” Medscape, 2018. Accessed March 25, 2019.
  3. Voskoboinik, Aleksandr, et al. “Alcohol and Atrial Fibrillation.” Journal of the American College of Cardiology, published December 2016. Accessed March 25, 2019.

A high-density electroanatomic mapping study of 75 patients with atrial fibrillation (AF) has concluded that even a regular alcohol intake—up to 14 standard drinks per week—is associated with impairments in electrical signaling and more electrical evidence of scarring, signaling worse outcomes.

“Excessive alcohol consumption has emerged as a potentially modifiable risk factor for AF,” Aleksandr Voskoboinik, MBBS, and coauthors wrote in Heart Rhythm Jan. 10. “Both binge drinking and habitual alcohol consumption have been implicated in electrical and structural changes involving the left atrium.”

Over-the-top alcohol intake can result in the shortening of atrial refractoriness and slowing of intra-atrial conduction, Voskoboinik and colleagues said, and binge drinking has also been linked to contractile dysfunction related to oxidative stress, mitochondrial damage and cardiac steatosis. And while there’s an established connection between regular alcohol intake and AF, there’s a paucity of electrophysiological data on the subject.

The Dangers of Alcohol and Caffeine for AFib

Atrial fibrillation (AFib) is a common heart rhythm disorder. It affects 2.7 to 6.1 million Americans, according to the Centers for Disease Control and Prevention (CDC). AFib causes the heart to beat in a chaotic pattern. This can lead to improper blood flow through your heart and to your body. Symptoms of AFib include shortness of breath, heart palpitations, and confusion.

Doctors typically prescribe medications to prevent and ease AFib symptoms. Minor procedures can also restore normal cardiac rhythm. Lifestyle changes are often as important as medicinal treatments for people with AFib. Lifestyle changes include food swaps — less fat and sodium, more fruits and vegetables — as well as avoiding other factors that can trigger an AFib episode. Top among these factors are alcohol, caffeine, and stimulants.

Read more: What do you want to know about atrial fibrillation? “

Alcohol, caffeine, stimulants, and AFib


If you have AFib, pre-dinner cocktails, or even a few beers while watching a football game could pose a problem. Research shows that a moderate to high alcohol intake increases a person’s risk for an AFib episode. The results of a study published in the Canadian Medical Association Journal found that moderate alcohol consumption increased a person’s risk for AFib symptoms. This was especially true for people aged 55 or older.

Moderate drinking — whether it’s wine, beer, or spirits — is measured as one to 14 drinks per week for women and one to 21 drinks per week for men. Heavy drinking or binge drinking more than five drinks in a day also increases a person’s risk for experiencing AFib symptoms.


Many foods and drinks, including coffee, tea, chocolate, and energy drinks contain caffeine. For years, doctors told people with cardiac problems to avoid the stimulant. Now scientists aren’t so sure.

A 2005 study published in the American Journal of Clinical Nutrition uncovered that caffeine is only dangerous for people with AFib at very high doses and in extraordinary circumstances. The researchers concluded that most people with AFib could handle normal amounts of caffeine, like what’s found in cups of coffee, without worrying about potential AFib-related problems.

The bottom line is that recommendations for caffeine intake with AFib vary. Your doctor has a better understanding of your situation, your sensitivities, and the risks you face if you consume caffeine. Talk with them about how much caffeine you can have.


Alcohol and caffeine consumption can make your body dehydrated. Dehydration can cause an AFib event. A dramatic shift in your body’s fluid levels — from consuming too little or even too much liquid — can affect your body’s normal functions. Sweating during summer months or from increased physical activity can make you dehydrated. Viruses that cause diarrhea or vomiting can also cause dehydration.


Caffeine isn’t the only stimulant that can affect your heart rate. Some over-the-counter (OTC) medications, including cold medicines, can trigger AFib symptoms. Check these types of medications for pseudoephedrine. This stimulant may cause an AFib episode if you’re sensitive to it or have other heart conditions that affect your AFib.

Learn more: Lifestyle changes to help manage AFib “

Talk with your doctor

Time with your doctor is important. Doctor’s visits are often brief. That leaves you with little time to cover a lot of questions or concerns you may have about your AFib. Be prepared before your doctor walks in so you’re able to cover as much as possible in the time you have together. Here are a few things to remember when you are speaking with your doctor:

Be honest. Many studies have shown that people often underestimate how much alcohol they consume. For your own health, tell the truth. Your doctor needs to know how much you’re consuming so they can properly prescribe medications. If your alcohol intake is a problem, a doctor can connect you with the help you need.

Do some research. Speak with family members and create a list of relatives who have any history of heart disease, stroke, high blood pressure, or diabetes. Many of these cardiac conditions are inherited. Your family history can help your doctor assess your risk for experiencing AFib episodes.

Write down your questions. Amid a flurry of questions and instructions from your doctor, you may forget the questions you have. Before you head into your appointment, create a list of questions you have. During your appointment, use them as a guide to talk with your doctor about your condition, risks, and behaviors.

Bring someone with you. If you can, bring a spouse, a parent, or a friend with you to each doctor’s appointment. They can take notes and instructions from your doctor while you’re being examined. They can also help you stick with your treatment plan. Having support from a partner, family, or friends can be really helpful if the treatment plan involves major lifestyle changes.

Podcast: Play in new window |

Are you like me, do you enjoy having a cocktail or beer occasionally? Do we have to give up alcohol if we have atrial fibrillation? In this week’s Q&A session I discuss binge drinking vs. heavy drinking vs. moderate drinking and what afibbers must avoid. I also provide a tip that might help reduce the risk of afib episodes while drinking.

***Begin Transcript***

David writes, “I have paroxysmal AFib. I have a beer from time-to-time, but I’m wondering if I should stop drinking all together. I’ve heard that it can be bad for people with AFib. What are your thoughts?”

Well, David, if you’re a regular reader of my blog, you know that I used to be a heavy drinker. In fact, my first episode occurred after a night of heavy drinking. That was back on Father’s Day in 2006. Needless to say, ever since then, I have not been a heavy drinker.

I have continued to drink since then, but I am now a moderate drinker, and I’m not even sure I would be classified as a moderate drinker, because technically, according to the dietary guidelines for Americans, moderate drinking is defined as men having two drinks a day or women having one drink per day. I certainly don’t drink even that much. When I drink these days, it’s typically on a Friday and/or a Saturday, and at most, I’ll have two drinks. And sometimes, if I’m going really crazy I might have three drinks. But that’s about the most that I will drink.

Now, there are no studies or research that provide any clues or insight on moderate alcohol consumption and its effects on AFib, whether it makes it worse, or whether you have more episodes, or it makes you go from paroxysmal AFib to persistent, or anything like that. And I think most doctors would agree that moderate alcohol consumption, even for AFibbers is probably okay, as long as it doesn’t trigger episodes for you. And that is the big issue with alcohol and AFibbers: does it or does it not trigger episodes?

If you have AFib, and you have a drink, and you have an episode, then obviously alcohol’s probably gonna be a no go for you. There are a lot of people that have AFib that can tolerate alcohol. I’m one of those. I can sit down, and have two, and even three drinks, and I don’t go into AFib. And I can tolerate different types of alcohol. I can drink beer, hard liquor, wine, and I’m fine.

Now, I will say, I do have palpitations when I drink (if I have more than two drinks). In fact, my PVCs and PACs will pick up quite a bit, and will flare up quite a bit after I have two or three drinks, but I never go into AFib, and I’ve never gone into AFib from drinking one to three drinks in a session. It really is an individual thing. Again, if you drink and you have episodes, then that’s probably not gonna work for you. But if you can tolerate alcohol, a drink or two, you’re probably gonna be okay.

Now, there are couple things though that I need to talk about here, and that is, different types of alcohol might have a different effect on you. For instance, you might be able to drink beer just fine, but if you drink red wine, boom, you go into AFib. Or you might be able to tolerate red wine just fine, but if you have hard liquor, you have an episode.

I guess what I’m trying to say is, if you try drinking and you go into an episode, if drinking is really important to you… And let’s face it, in social situations, a lot of us like to have a drink or two in social situations. If that’s really important to you, then try a different type of alcohol the next time you drink. If you had red wine and you had an episode, maybe next time, just try having a beer, and maybe like a light beer versus one of those heavy craft beers, just to see what happens. And if you tolerate that, okay, well, then you might be okay having an occasional beer.

The other thing though, I wanna talk about, is that’s a big no no for people with AFib, is binge drinking or heavy drinking. These are definitely no goes for AFibbers. So let’s define these different categories of drinking.

Binge drinking is defined as men drinking five drinks or more in a session, and women drinking four or more drinks in a session. That’s binge drinking. And binge drinking can lead to what’s called Holiday Heart Syndrome. And basically, what that means is, binge drinking, you have, again, if you’re a man, five or more drinks in a session, boom, you go into AFib, maybe not immediately, maybe the next morning, and you will develop, it’s just called Holiday Heart Syndrome, just basically means AFib from a session, or a night, or day of heavy drinking. That’s what happened to me back in 2006, that they probably would have classified that as Holiday Heart Syndrome.

Now, heavy drinking is, drinking for men, drinking three drinks or more on a daily basis, and women drinking two drinks or more on a daily basis. These types of drinking, binge drinking, heavy drinking, are a no go for AFibbers, because it can cause, probably, for most of us, it’s gonna cause us to go into AFib.

There’s an interesting article on and I’ll have a link to this article on my website, but they cited a study done by the Canadian Medical Association Journal in 2012. They found that for people with AFib, binge drinking is as harmful to the heart as heavy drinking on a regular basis. Again, just further emphasizing that binge drinking, heavy drinking, these are definitely two categories you don’t wanna play around with if you have AFib.

But again, moderate drinking, it’s probably gonna be okay for most people with Afib. But again, if you drink and you have an episode, then yeah, you’re probably gonna have to call it quits.

And just one other quick caution on drinking, I read on an article on WebMD that alcohol can raise your risk of bleeding if you’re on Warfarin or Coumadin. Now, the article didn’t reference the newer oral anticoagulants like Eliquis, and Xarelto, and Pradaxa. I don’t know what the effects of alcohol are on those types of blood thinners, but the bottom line is… I guess the main point is, if you are taking a blood thinner and you’re gonna be a moderate drinker, you might want to talk to your doctor about that just to make sure that there’s not going to be any issues with the alcohol and the prescriptions that you’re on.

And one other thing too, that you can do to reduce your risk of having Afib episodes when you’re drinking, is stay well hydrated. That’s very important. One of the things that I try to do… Or I don’t try, I do, whenever I’m drinking, whether I’m at home or I’m out, whatever, I try to match… I try to drink as much water as I am drinking alcohol.

If I’m somewhere, and let’s say I have a 20 ounce beer, I will try to have 20 ounces of water at the same time, or shortly after. I try to drink as much water as I’m consuming alcohol. And that’s especially important in the summer when you’re hot and sweaty because you’re even more prone to dehydration and electrolyte imbalances. It’s important that you stay well hydrated. Even if I go out with my wife and I have a cocktail, I will order a glass of water and I will drink as much water as that one cocktail just to stay well hydrated. That’s a tip that you’ll want to implement if you are going to be drinking while you have Afib.

So there you have it. I’m gonna have links to other resources that talk about alcohol and atrial fibrillation on my website, so if you visit my website again,, and in the search box, just search for alcohol and atrial fibrillation, this blog post should pop up. I’ll have a transcript of this audio, as well as the links to some of these other resources that I found on this topic.

And then, also, again, as always, if you have a question for me, contact me at And everybody that contacts me, I reply to every email I get, so you will get a personal reply or a personal answer from me, regardless of whether or not I feature your question on these Q & A audio sessions. There you go. David, I hope that answers your question. Thanks for listening and have a great day.

***End Transcript***

Other articles that discuss the topic of alcohol and atrial fibrillation:

  • Atrial Fibrillation and Alcohol: Is It Safe to Drink?
  • Does Alcohol Cause AFib?
  • The Dangers of Alcohol and Caffeine for AFib
  • Atrial Fibrillation and Alcohol
  • Alcohol and Atrial Fibrillation: Questions, Conflicts and Choices…
  • Holiday Heart Syndrome: What you need to know about holiday binge drinking

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