Atrial Fibrillation and Alcohol: Is It Safe to Drink?

For some people with atrial fibrillation, drinking alcohol in any amount may be too much, but moderate drinking may be okay for others. Learn about alcohol as a trigger for atrial fibrillation symptoms.

Medically reviewed by Pat F. Bass III, MD, MS, MPH

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 problemsmanaging your atrial fibrillation symptoms, talk with your doctor.

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