New data presented at the American College of Cardiology’s 70th Annual Scientific Session show that alcohol appears to have an immediate—or near-immediate—effect on heart rhythm, significantly increasing the chance that an episode of atrial fibrillation (AFib) will occur.


Gregory M Marcus, Eric Vittinghoff, Isaac R Whitman, Sean Joyce, Vivian Yang, Gregory Nah, MA, Edward P Gerstenfeld, MD, Joshua D. Moss, MD, Randall J. Lee, MD, PhD, Byron K. Lee, MD, Zian H. Tseng, MD, MAS, Vasanth Vedantham, MD, PhD, Jeffrey E Olgin, MD, Melvin M Scheinman, MD, Henry Hsia, MD, Rachel Gladstone, Shannon Fan, Emily Lee, Christina Fang, Kelsey Ogomori, Robin Fatch and Judith A Hahn


American College of Cardiology. 2021. Alcohol May Have Immediate Effect on Atrial Fibrillation Risk, Events - American College of Cardiology. [online] Available at: .

American College of Cardiology’s 70th Annual Scientific Session
Release date

Acute Alcohol Consumption and Discrete Atrial Fibrillation Events



AFib is the most common heart rhythm disorder. It is often characterized by a rapid, chaotic and fluttery heartbeat. People can experience a range of symptoms. Some may not feel anything, while others are overcome with severe shortness of breath, fatigue, fainting or near fainting spells and a disconcerting sensation that the heart is beating out of control. AFib also results in costly use of health care services, including visits to the emergency department, hospitalizations and procedures each year. Over time, AFib can lead to heart failure, stroke and dementia if untreated.


Researchers enrolled 100 patients with paroxysmal or intermittent AFib, which tends to go away within a short period of time (unlike chronic AFib). Patients in the study were 64 years old on average; the majority were white (85%) or male (80%). Past medical history, medications and lifestyle habits were assessed through chart reviews and patient interviews. Each participant was fitted with a wearable heart monitor that continuously tracked their heart rhythm and an ankle sensor to objectively detect when more than two to three drinks were consumed on a given occasion. Participants were asked to press a button on the heart monitor each time they had an alcoholic drink. Finger stick blood tests measuring alcohol consumption in the previous few weeks were also used to corroborate self-reported drinking events. Because researchers used repeated measurements from the same individual, they served as their own control over time.


The study found the following results:

  • Overall, more than half (56%) had an episode of AFib during the four-week study.
  • Just one glass of alcoholic beverage was associated with twofold greater odds of an episode of AFib occurring within the next four hours.
  • Among people having two or more alcoholic beverages in one sitting, there was a more than threefold higher chance of experiencing AFib.
  • Every 0.1% increase in inferred blood alcohol concentration over the previous 12 hours was associated with an approximate 40% higher odds of an AFib episode.
  • The total alcohol concentration over time also predicted the chance AFib would occur.  

Research in context

Based on our data, we found that alcohol can acutely influence the likelihood that an episode of AFib will occur within a few hours, and the more alcohol consumed, the higher the risk of having an event,” said Dr. Gregory M. Marcus, lead author of the study and cardiologist and professor of medicine at the University of California, San Francisco, as per American College of Cardiology.

Dr. Gregory M. Marcus, lead author of the study and cardiologist and professor of medicine at the University of California, San Francisco

This is the first study to objectively demonstrate and quantify the real-time relationship between alcohol consumption and AFib episodes. While this study was limited to people with intermittent AFib, Dr. Marcus says it’s reasonable to extrapolate the fact that in many people alcohol may be the main trigger for an initial episode.

Next Marcus and his team will look at how these results, which are limited to those with intermittent AFib, may apply to the general population. They also hope to identify other factors that may influence the relationship between alcohol and AFib, including genetics.

Source Website: American College of Cardiology