Don't have another. Alcohol consumption can raise atrial fibrillation risk

[6 min read]

In this article: 

• Atrial fibrillation, or Afib, is a form of cardiac arrhythmia that can lead to stroke or heart failure.
• A Swedish expert discusses the relationship between Afib and alcohol consumption. 
• More than one drink per day can increase the threshold of Afib risk. 

September marks National Atrial Fibrillation (Afib) Awareness Month, when we help raise awareness about this complex condition. Afib is a form of a cardiac arrhythmia that originates in an upper chamber of the heart and can cause elevated heart rates well over 100 beats per minute. When not in check if these elevated rates are sustained, they can lead to weakening of the heart otherwise known as heart failure. In addition, when the upper chamber is “quivering”, if you will, it can cause blood to pool, stagnant or pooling blood can form a clot that when released can travel to the brain and cause a stroke.

These adverse effects of atrial fibrillation are mediated by medications to control the heart rate and blood thinners to prevent strokes in at risk patients. Additionally, there are several methods used to reset the heart to a normal rhythm including electrical cardioversion. 

During a recent meeting of cardiovascular clinicians at Swedish, David Lam, M.D., co-director of the Swedish Comprehensive Afib Network (SCAN) and the Swedish Afib clinic, gave a sobering presentation about the relationship between Afib, alcohol consumption, exercise and dementia. With the holidays just around the corner, Dr. Lam’s presentation, “Afib Correlation with Alcohol, Exercise and Dementia: Fact or Fiction?” was most timely. In the United States alcohol sales increase in the period between Thanksgiving and New Year’s by as much as 35%. And New Year’s Eve is one of the biggest drinking holidays in the United States second only to Mardi Gras in some comparisons.

So, what is it about alcohol that increases the risk of developing atrial fibrillation?  

“Alcohol can be both a trigger and sustainer of Afib through atrial remodeling and autonomic effects. This means alcohol can change the cellular structure of the heart through inflammation and stress which impacts the ability for the cardiac cells to communicate with each other.,” says Dr. Lam. “In addition, the autonomic effect of sympathetic activation and vagal withdrawal, the same responses your body uses when responding to danger, increases the heart rate. The combination of these effects alcohol has on the cardiac system creates a perfect environment for Afib.”    

How much alcohol is too much? And does the type of alcohol matter? And can cutting back on significant alcohol consumption help? 

Multiple studies, some as recent as 2022, appear to show that drinking one drink per day poses a minimal risk of developing atrial fibrillation. When consumption is increased past the 1 drink a day threshold, risk of developing atrial fibrillation went up linearly. The studies had variable conclusions as to whether one type of alcohol: wine, beer, hard cider, or spirits, increased the risk of atrial fibrillation over another.  There also seemed to be little difference between gender and that men and women carried the same risk of development of atrial fibrillation at the same consumption levels.

When are we most at risk of developing atrial fibrillation after alcohol consumption? 

According to Dr. Lam’s presentation, the window between zero and four hours after consumption carried the highest incidence of atrial fibrillation occurrence and the risk slowly decreased up to 12 hours from consumption. For patients who drink significantly, more than two drinks per day or 14-16 drinks per week, cutting down on alcohol consumption is a worthy endeavor and it does have an impact over time on reducing the reoccurrence of atrial fibrillation.      

Cheers to a healthy, happy holiday season and some food for thought to sub out a few of those alcoholic drinks for sparkling cider. 

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Find a doctor

If you've been recently diagnosed with AFib, the specialists at the Swedish AFib Clinic can help. Call us at 206-215-4545 to schedule an appointment or visit swedish.org/AFib for more information.

Whether you require an in-person visit or want to consult with a doctor or heart specialist virtually, you have options. Swedish Virtual Care connects you face-to-face with a nurse practitioner who can review your symptoms, provide instruction and follow-up as needed. If you need to find a physician, caregiver or advanced care practitioner, you can use our provider directory.

Additional resources
Swedish reimagines care for AFib
Atrial Fibrillation Awareness

This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.

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