The evidence

Alcohol and AFib risk, with and without drinking

By GyroscopeUpdated November 15, 20265 sources

For people with atrial fibrillation, stopping drinking is one of the few changes a randomized trial has proven. In 140 regular drinkers with AFib, it came back within six months in 53 of every 100 who stopped, against 73 of every 100 who kept drinking. For everyone else, a drink a day went with a 16% higher risk of getting AFib in the first place.

In AFib, the top chambers of the heart quiver instead of beating, and the heart races or flutters. Ask people with AFib what sets it off and many will say a night of drinking. For years doctors treated that as a story. Then they measured it.

The trial

In 2020 doctors at six hospitals in Australia enrolled 140 adults with AFib who drank 10 or more standard drinks a week, about 17 on average (Australian drinks of 12 g). Half were asked to stop and half carried on. The group asked to stop cut from about 17 drinks a week to about 2. The other group drank a little less too, about 13.

Over six months, after a two-week settling-in period, AFib came back in 37 of the 70 who stopped (53%) and 51 of the 70 who kept drinking (73%). The ones who stopped went longer before it came back, and spent less of their time in AFib: a median of 0.5% of the time against 1.2%.

A drink can set off an episode

In 2021, 100 people with on-and-off AFib wore a heart monitor and an ankle sensor that detects alcohol through the skin for four weeks, and pressed a button every time they had a drink. An episode was twice as likely in the four hours after one drink, and more than three and a half times as likely after two or more.

Getting AFib in the first place

A 2021 study followed 107,845 people in Europe for a median of almost 14 years. Each daily drink of 12 g raised the risk of new AFib by 16%, and it didn’t matter whether the drink was beer, wine or spirits. NIAAA’s summary for doctors says that “even less than one drink per day” is linked to a higher risk.

That’s a relative number, so it depends on your starting risk. If your odds are already high, the same 16% adds more people.

What your watch sees

Your heart rate runs higher on drinking nights. In 20,968 WHOOP members, one drink more than usual, against one less, came with a sleeping heart rate 2.4 to 2.8 beats higher. If your watch or ring ever flags a possible AFib, take it to your doctor, since only a doctor can diagnose it.

What we’d do

If you have AFib, stop drinking or get as close to zero as you can, and tell your cardiologist what you drink. The trial shows it works. If you don’t have AFib but you’re at higher risk, fewer drinks is one of the easiest things to change. If you notice your heart racing or skipping after drinking, write down what you drank and when, and bring it to your doctor. NIAAA notes that a single binge can set off an abnormal rhythm.

If you drink heavily every day, talk to a doctor before you stop, because withdrawal can become dangerous.