Alcohol May Cause You To Develop Irregular Heartbeats

It’s no secret that alcohol can harm your health. But in a pop quiz, many of us would link alcohol with liver damage — not connect the dots between drinking and developing heart problems, like atrial fibrillation (AFib). We might even think that alcohol in moderation is good for the heart, thanks to the longstanding myth about red wine.

So, let’s set the record straight: Alcohol consumption, in any amount, isn’t doing your heart any favors. In fact, it may even harm your heart. One of the major reasons? It creates just the right conditions for abnormal rhythms, especially AFib, to develop or get worse.

Cardiac electrophysiologist Mohamed Kanj, MD, explains why alcohol and atrial fibrillation simply don’t mix.

Links between alcohol and atrial fibrillation

When it comes to atrial fibrillation, alcohol serves up a triple whammy by:

• Raising your risk: Regularly drinking alcohol — even at moderate levels — increases your risk of developing atrial fibrillation at some point during your lifetime. Even if your heart rhythm is normal now, drinking alcohol could change that down the road.
• Making existing atrial fibrillation worse: If you already have a diagnosis, alcohol becomes even more dangerous. “AFib is a progressive disease, meaning it gets worse over time,” Dr. Kanj explains. “That progression will be faster if you continue drinking alcohol.”
• Making treatments less effective: Nowadays, plenty of AFib treatments are available, but they work best without alcohol in the mix. “When you drink alcohol, every therapy available to us becomes less effective,” Dr. Kanj emphasizes. “This means your symptoms may persist, get worse or require other treatments.”

In all these scenarios, no amount of alcohol is truly safe (more on that in a moment).

How alcohol impacts heart rhythm

Alcohol damages your heart in ways that invite atrial fibrillation to develop. That’s true even if you’re a casual drinker — for example, you routinely have a glass of wine with dinner or throw back a couple of beers at the ballgame. Most of us would consider drinking in moderation to be pretty low risk. But that’s simply not the case when it comes to AFib.

“Drinking a little bit of alcohol every day can slowly cause changes that lead to atrial fibrillation,” Dr. Kanj warns.

These changes include:

• Cell death: “Alcohol is a toxin at any dose,” Dr. Kanj points out. “But the more you take in, the more it acts.” He adds that it can actually kill your heart muscle cells — including the cluster of cells, called the sinoatrial (SA) node, that sets the pace for your heartbeat. “That node starts dying at a faster rate the more you drink.”
• High blood pressure: Drinking raises your blood pressure over time. When your blood pressure goes up, your heart gets bigger. This type of structural change raises your risk of developing atrial fibrillation.
• Poor sleep: Alcohol disrupts your sleep cycle, which translates to low-quality sleep and a host of related health issues, including high blood pressure. “Sleep disruptions also put your heart into what we call a heightened state, where arrhythmias are more likely,” Dr. Kanj says.

Binge drinking, or having four or five drinks within two hours, is especially risky. Dr. Kanj shares that having too much alcohol too fast can lead to a short-term arrhythmia called holiday heart syndrome. While your heart rhythm may return to normal in a couple days, continued heavy drinking can lead to heart damage and repeated AFib episodes.

He also cautions that when you have AFib, drinking alcohol increases your risk of:

• Thromboembolism (a blood clot that breaks free from where it started, travels through your blood and blocks a blood vessel)
• Ischemic stroke
• Bleeding
• Death

These risks are further elevated if you take blood thinners or drink heavily.

Is any amount of alcohol safe?

We hate to be the bearers of bad news, but no amount of alcohol — even in moderation — is truly safe if you want to avoid or manage AFib.

“From an arrhythmia standpoint, abstinence is best,” Dr. Kanj stresses.

If you’ve been diagnosed with AFib, taking a zero-alcohol approach can help you:

• Have fewer AFib episodes
• Feel better from day to day
• See more effective results from treatments

“The success rate for an ablation, a common heart procedure, is better for those who cut down on alcohol compared to those who continue their usual drinking,” he adds. “But the success rate is highest for those who don’t drink at all.”

If you opt for an occasional drink, Dr. Kanj offers some advice:

• Learn what counts as a drink. You might think you’re having “just one” when, in fact, your friend (or that friendly bartender) was feeling extra generous. A standard drink is typically 12 ounces of beer, 8 ounces of malt liquor, 5 ounces of wine or 1 to 1.5 ounces of spirits.
• Know the limit. “Current guidelines suggest no more than two drinks a day for men, and no more than one drink a day for women — but no more than three in a week,” Dr. Kanj shares. “Still, your doctor may advise even fewer. Ask them to weigh in.”
• Keep track. Many of us think we drink rarely when, in fact, it may happen more often than we realize. The best way to know for sure? Keep a log for a few months. Track the date, time, and the type and amount of alcohol. The results might surprise you.
• Seek support. Drinking less isn’t always a matter of willpower. Other factors can come into play, including your genes or mental health conditions. If you think you may have alcohol use disorder — which is common and treatable — talk to a healthcare provider.

Final thoughts

Cutting back on alcohol is one of the best ways to prevent atrial fibrillation or manage it once you’re diagnosed. That means it may be time to make some changes to your daily routine.

Dr. Kanj points out that for many people, avoiding alcohol can feel like a tall order because drinking and socializing often go hand in hand. You meet colleagues for happy hour. You celebrate birthdays at the bar. It can become second nature.

But he offers a challenge: “The next time you’re at a bar or restaurant, ask to see the list of nonalcoholic drinks. It’ll likely be longer than your arm. Choose one and try it in place of your usual drink. You might find it easier than you thought to go out and have fun in ways that aren’t so hard on your heart.”