After water and tea, alcohol is one of the most widely consumed substances worldwide. A well-known participant at get-togethers and dinner parties, it’s a common part of our social lives. It can be a fun addition to an event, but it affects the body in distinct ways, most notably the liver.
What we don’t think about as often is how it impacts the heart and its electrical system. For people prone to irregular heartbeats like atrial fibrillation, the occasional libation can influence when and how arrhythmias occur.
With the holidays around the corner, seasonal soirees will be in full swing and the spirits will flow. Knowing the effect those cocktails have on your heart will shape choices that reduce the risk of exacerbating or developing an arrhythmia.
Alcohol Influence
Alcohol’s effects on the heart are complex. Classified as a depressant, alcohol influences electrical activity and increases the risk of irregular heartbeats, often in more harmful and unpredictable ways than caffeine or sugary drinks – especially for those with Afib. Research indicates that alcohol directly affects the electrical properties of cardiac cells, increasing their susceptibility to arrhythmias.1
“Holiday heart syndrome” is a well-documented phenomenon where binge drinking episodes (consuming large amounts of alcohol over a short period) trigger sudden arrhythmias. It’s aptly named because the effect is most commonly observed during weekends or holidays, when alcohol consumption tends to spike. This is significant because it highlights how even short-term, heavy alcohol use can destabilize heart rhythm in otherwise healthy people without preexisting heart conditions.
Even moderate, consistent alcohol intake raises Afib risk. A long-term observational study revealed that just one alcoholic drink daily, equivalent to a glass of wine, beer, or an ounce of spirits, was associated with a 16% higher chance of developing Afib compared to abstaining entirely. 2 For individuals already diagnosed with Afib, alcohol’s impact can be immediate: studies using continuous heart rhythm monitoring demonstrated that a single drink doubled the odds of experiencing an Afib episode within four hours.3
Beyond electrical disturbances, alcohol also induces structural changes in the heart. Moderate drinkers showed more scarring and disrupted electrical signaling in the left atrium (one of the heart’s upper chambers) compared to light drinkers or nondrinkers. These changes correlate directly with the severity of Afib, potentially creating a vicious cycle of arrhythmia and cardiac remodeling (a process where the heart’s shape, size, and function change in response to ongoing stress or damage).4
When it comes to age, youth doesn’t offer immunity from alcohol’s cardiac effects. Recent research involving more than 1.5 million adults aged 20 to 39 linked moderate to heavy drinking with a substantially increased risk of developing Afib, even after adjusting for other cardiovascular risk factors. Those with heavy, sustained alcohol use had nearly a 50% higher risk compared to non-drinkers.5
Alcohol’s arrhythmogenic effects are thought to result from several mechanisms: direct toxic impact on cardiac cells, disruptions in electrolyte balance caused by its diuretic properties, increased sympathetic nervous system activity, and inflammation. (The sympathetic nervous system triggers the body’s fight-or-flight response, increasing heart rate and contractility.) Even after drinking has stopped, the “hangover” phase is a form of mild alcohol withdrawal that’s characterized by increased sympathetic activity and decreased recovery periods in cardiac tissue, both of which heighten arrhythmia risk.6
Limiting alcohol consumption or abstaining altogether is the safest recommendation for individuals concerned about Afib or other arrhythmias. Even small amounts can alter the heart’s electrical stability, particularly in those predisposed to irregular rhythms.
Beware of Sugary Drinks
Avoiding sugar has a positive effect on your waistline, but it can also have an impact on your heart. Research shows that consuming glucose, fructose, or other carbohydrates can reduce heart rate variability (HRV), especially when blood sugar spikes or drops quickly.7Our hearts speed up and slow down depending on the body’s needs; HRV is a measure of how well your heart can adapt to changes in activity, stress, or other demands that affect heart rate. Reduced HRV is a sign that the heart is under stress and less able to respond to changes, which can make arrhythmias more likely.
After tracking over 200,000 adults who were free of AFib at the start of a 10-year study, adults who drank two liters or more per week of sugar-sweetened beverages had a 10% higher risk of developing atrial fibrillation. Even artificially sweetened drinks were linked to a 20% increased risk. (Researchers equated two liters of artificially sweetened drinks to approximately one 12-ounce can per day.)8
Sugar is processed by the liver in ways similar to alcohol, which means it can stress your metabolism, autonomic nervous system, and cardiovascular system in overlapping ways. This means sugar-laden alcoholic drinks, like many holiday cocktails, could add stress to cardiac rhythm, particularly for those with Afib or sensitivity to irregular heartbeats. Both sugar and alcohol can create temporary spikes in heart rate and palpitations, and when combined, they may increase the chance of skipped beats or arrhythmic episodes.
High or frequent sugar consumption plus alcohol can spell bad news for people already prone to irregular heart rhythms. While occasional combinations may not cause issues for everyone, those with a history of atrial fibrillation or sensitivity to cardiac rhythm changes may want to steer clear of mixing the two.
Have a Heart-Healthy Holiday Season
Your heart’s steady beat supports every moment of your life. Because substances like sugar and alcohol can negatively impact it, pay attention to how your heart reacts.
Notice if palpitations, skipped beats, or unusual sensations arise and consider adjusting your intake accordingly. When in doubt, err on the side of caution: smaller amounts or avoiding these substances altogether can reduce risks.
This information is not a substitute for professional medical advice. Always consult your healthcare provider before making changes to your diet or lifestyle, especially if you have a history of heart rhythm issues. If you are experiencing a medical emergency or concerning heart dysfunction, call 911.
Dr. Tordini is a part of Florida Medical Clinic Orlando Health
- Jain, A., Yelamanchili, V. S., Brown, K. N., & Goel, A. (2024, January 16). Holiday Heart Syndrome. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK537185/.
- Bhatt, D. L. (2021, September 1). Alcohol and atrial fibrillation. Harvard Health; Harvard Health Publishing. https://www.health.harvard.edu/heart-health/alcohol-and-atrial-fibrillation.
- Jain, A., Yelamanchili, V. S., Brown, K. N., & Goel, A. (2024, January 16). Holiday Heart Syndrome. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK537185/.
- Bhatt, D. L. (2021, September 1). Alcohol and atrial fibrillation. Harvard Health; Harvard Health Publishing. https://www.health.harvard.edu/heart-health/alcohol-and-atrial-fibrillation.
- Schmidt, K. (2021, November 30). Irregular heartbeat risk linked to frequent alcohol use in people under 40. Www.heart.org; American Heart Association. https://www.heart.org/en/news/2021/11/30/irregular-heartbeat-risk-linked-to-frequent-alcohol-use-in-people-under-40.
- Jain, A., Yelamanchili, V. S., Brown, K. N., & Goel, A. (2024, January 16). Holiday Heart Syndrome. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK537185/.
- Eckstein, M. L., Brockfeld, A., Haupt, S., Schierbauer, J. R., Zimmer, R. T., Wachsmuth, N. B., Zunner, B. E. M., Zimmermann, P., Erlmann, M., Obermayer-Pietsch, B., Aberer, F., & Moser, O. (2022). Acute Changes in Heart Rate Variability to Glucose and Fructose Supplementation in Healthy Individuals: A Double-Blind Randomized Crossover Placebo-Controlled Trial. Biology, 11(2), 338. https://doi.org/10.3390/biology11020338.
- American Heart Association Newsroom. (2024, March 5). Sweetened drinks linked to atrial fibrillation risk. American Heart Association. https://newsroom.heart.org/news/sweetened-drinks-linked-to-atrial-fibrillation-risk.
