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Jan 18, 2011

Alcohol and Atrial Fibrillation: A New Look

Heavy alcohol use significantly increases risk for atrial fibrillation.

Atrial fibrillation (AF) is the most common type of heart rhythm disturbance. It affects more than 2.6 million people in the United States alone and the numbers are growing. The real danger of AF comes when blood clots that form in the rapidly beating upper chambers of the heart escape into the blood stream and lodge in small vessels in the brain, lungs, and lower limbs. Even if you do not experience the telltale fast heartbeat and palpitations that signal a bout of AF, you are five times more likely to suffer a stroke from a blocked artery (ischemic stroke) than someone without the condition.

Many factors can contribute to AF and heavy alcohol use is high on the list. For some time doctors have observed a syndrome dubbed “holiday heart,” in which an otherwise healthy person experiences a lone episode of AF following a weekend of binge drinking. But the issue that has continued to elude researchers is whether heavy alcohol consumption on a regular basis will lead to chronic AF down the road. Further clouding the subject are numerous studies that have shown moderate alcohol intake to be a benefit to cardiovascular health.

In attempt to clarify the issue, scientists in Japan undertook a systematic analysis of 40 years of research involving AF and alcohol use. After eliminating all but the most relevant studies, they settled on 14 that collectively assessed the drinking patterns of over 130,000 subjects in Europe and North America.

The researchers split the subjects into lowest and highest alcohol intake categories and compared the risk of AF between the groups. Overall, the heavy alcohol users were at 50% higher risk for AF than the light drinkers or tea toddlers. Another interesting point the researchers uncovered was that AF risk rose in direct proportion to an individual’s level of alcohol intake. For each additional 10 grams of alcohol a person consumed on a daily basis (roughly equivalent to one extra drink) the likelihood of having AF grew 8%.  The study did not address whether the type of alcoholic beverage consumed--beer, wine, or spirits--made a difference to AF risk. 

Questions for You to Consider

  • Is it OK for me to drink alcohol?
  • This is a complex question best decided by you and your doctor based on your own health history. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), moderate alcohol use--up to two drinks per day for men and one drink per day for women and older people--causes few if any problems for most adults. (One drink equals one 12-ounce bottle of beer or wine cooler, one 5-ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits.) However, you should not drink at all if:  

    • You are pregnant or trying to become pregnant.
    • You have a medical condition that can be made worse by drinking. 
    • You plan to drive or do other tasks that require you to be alert.
    • You are taking medicines that interact with alcohol.
    • You have had a problem with alcohol in the past.
    • You are younger than age 21.  
  • Do wine, beer, and spirits all have the same health effects?
  • If you choose to drink alcohol, the key is moderation. Heavy drinking of any type of alcoholic beverage puts you at risk for serious conditions including high blood pressure, stroke, cancer, and obesity. However, researchers have observed that people who drink moderately may have a lower risk cardiovascular disease. Although no studies have directly compared the potential risk and benefits of different types alcoholic beverages some researchers speculate that antioxidant substances found in wine, particularly red wine, are responsible for the protective effect.

  • What is the connection between alcohol consumption and atrial fibrillation?
  • Scientists have a couple of theories about how the two factors interact.  Alcohol interferes with the heart’s electrical system and ability to maintain a steady rhythm.  It also directly affects the structure of the heart muscle.  Another speculation is that long-term heavy drinkers may have heart muscle changes that increase their risk of AF even before they show symptoms of chronic heart failure.

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