Alcohol, Athletes, and Atrial Fibrillation
Beer drinking with my buddies at Marster Springs Campground
Does alcohol cause atrial fibrillation (AF)?
We’ve been reading for years that a glass of wine or two can reduce the risk of heart attack and stroke; and it’s pretty clear if you’ve been hanging around at the finish lines of marathons, ultras, and long distance bicycling events that endurance athletes like to drink alcohol. Also, some studies have shown that endurance athletes have up to a five-fold increase risk of AF.
So . . . is alcohol consumption a risk factor for endurance athletes dealing with AF?
Uhh . . . yeah.
Drinking alcohol frequently raises the likelihood of developing AF, and more alcohol means more risk. One to three drinks (considered to be “moderate drinking”) increases the chances of AF, and “heavy drinking” (four or more drinks per day) increases the odds even more. It’s been suggested that every extra daily drink increases the risk by 8%!
Even if you aren’t a daily drinker so-called binge drinking, defined as five or more drinks in a day, also increases the chances of AF. (Some call it “binge drinking,” I might call it any weekend during my college years!)
Typical weekend from my college days
So how much alcohol is safe? Once you’ve been diagnosed with AF one or two drinks per day is probably safe, but three or more may be likely to trigger an episode. Also – make sure you figure out how much alcohol is one drink – a standard glass of wine versus a large glass of wine. A bottle of American light beer is going to be less alcohol than a bottle of craft brew IPA or stout.
My personal advice is that once you are diagnosed with AF the best move would be to quit alcohol altogether. That’s what I did. But consider that this advice is coming from a guy who is in permanent AF.
A very helpful WebMD article advises that even with moderate drinking you should avoid drinking every day:
Even if you drink moderately, experts suggest you take a few days off from drinking alcohol every week.
- Limit yourself to one to two drinks a day.
- Try to have 2 to 3 alcohol-free days every week.
- Talk to your doctor if you have an episode of AFib within an hour of drinking alcohol.
Exactly how does alcohol increase the chances of AF?
It isn’t clear why, but it is thought that hit might be related to increasing vagal tone. The more alcohol you drink, the higher the vagal tone. Another idea is that dehydration caused by alcohol triggers AF. A lot of people with AF know that alcohol can trigger their AF. Let’s face it – alcohol is basically a toxin with some pleasant side effects.
If you already are being treated for AF alcohol can interfere with the treatment – increase blood pressure, interact with anticoagulants, etc.
What is “Holiday Heart”?
Basically it is a nickname for the way heavy drinking around the holidays, so called “binge drinking” can trigger AF. According to Medscape:
Holiday heart syndrome most commonly refers to the association between alcohol use and rhythm disturbances, particularly supraventricular tachyarrhythmias in apparently healthy people. Similar reports have indicated that recreational use of marijuana may have corresponding effects.
The most common rhythm disorder is atrial fibrillation, which usually converts to normal sinus rhythm within 24 hours. Holiday heart syndrome should be particularly considered as a diagnosis in patients without structural heart disease and with new-onset atrial fibrillation. Although the syndrome can recur, its clinical course is benign, and specific antiarrhythmic therapy is usually not indicated. Interestingly, even modest alcohol intake can be identified as a trigger in some patients with paroxysmal atrial fibrillation.
Finally – what is meant by “Drinker’s Heart” (a.k.a “beer drinker’s heart”)?
That’s cardiomyopathy, a serious disease of the heart muscle, related to chronic heavy drinking. Don’t let it happen to you. It’s bad.
I would love to have any readers with comments post them below. I’d love to hear from athlete’s with atrial fibrillation who have had experience with alcohol as a trigger. Thanks for reading.
A Fib Runner - Distance Running and Mountain Biking With Atrial Fibrillation 
I’m a 39 year old female who was diagnosed with af 4 years ago. The minute I consume any alcohol, even a small glass of wine I start having palpitations. The last time I consumed 3 glasses of wine I was still feeling the effects days later. I now do not drink any alcohol at all as the symptoms are just too much to deal with and make me feel ill.
Thanks so much for your comment.
After my Ablation, I went into AFIB a few times but cardioverted in most of them and now AFIB free for more than 4 years.
The last time I went out of rhythm was because I drank too much. It was a combination of drinking shooters(I nearly never do it, I usually count my alcohol intake), dehydration and an early morning Mountain bike ride.
I normally drink light beers with an alcohol percentage of about 2,4%(3 beers at most) or craft beers but not more than 2 because their alcohol levels tend to be about 5-6% in South Africa.
My cardiologist is dead against alcohol. He has told me many times of students that he sees in the ER that go into AFIB because of alcohol.
Very good post thx.
Thanks for your kind words – it looks like you are learning your limit as you go!
Thanks for the article.
I developed PAF in February 2016 and it was a very unpleasant experience. The week leading up to my first episode, I was on holiday drinking beer each night and running most days. I’ve always enjoyed drinking beer. I’m usually a weekend drinker. I used to consume way over the recommended limit. A few years before my first AF episode, I would wake up with a pounding heart after drinking beer. This was the warning sign about my condition, which I ignored.
As I have read with many others who suffer this condition, you learn to cope with AF. You understand your limitations and make adjustments.
I have been a runner for most of my life. I was a very good club runner in my day.
Today, I am 51 years old. I exercise 6 days per week. 3 runs, 2 swims and 3 strength and conditioning sessions. I exercise comfortably. It’s not very often I push hard, if at all. I have been on a low carb high fat diet for over 6 months. I drink very little alcohol. This combination is working for me. I’ve not had an AF episode for over a year. I still get palpitations/flutters, which last no longer than a few minutes when they occur. I’m in the best shape I’ve been in for years.
I believe that alcohol and sugar are major contributing factors for my AF episodes.
Thanks for your informative, candid comment. I am happy to hear all is going well with you.
I remember a 5k race in which I was in afib at the start of the race. My race pace was way off. About half way through the race I converted back to normal rhythm. I finished the race strong. The post race area did not have the typical drinks and snacks. Instead there was water, beer, and pretzels. I went for the beer. This put me back into afib about 30 minutes later. I learned an import lesson, hydrating is much better than de-hydrating.
Thanks for the helpful comment!