Can I Drink Alcohol With Atrial Fibrillation?

Atrial fibrillation (AFib) is a heart rhythm disorder that affects more than 46 million people worldwide. It’s a potentially dangerous condition that has been linked with stroke and heart attacks, but it can be managed with lifestyle adjustments and, in some cases, medication. If you’ve been diagnosed with AFib, you probably have a lot of questions about how to stay safe and healthy — but what about alcohol? Can you enjoy a glass of wine with dinner or celebrate with a champagne toast, or does alcohol need to be avoided entirely? This blog post delves into the relationship between alcohol and AFib, offering insights and guidelines to help you make informed decisions.

What Is AFib?

Atrial fibrillation, often referred to as AFib, is the most common type of heart arrhythmia. An arrhythmia is a disturbance in the normal rhythm of the heart, which can lead to abnormal blood flow, excessive strain on heart tissue, discomfort, and decreased blood flow to the brain.

Blood moves into the heart by starting in the right atrium, then moving to the left ventricle and into the lungs. The lungs infuse our blood with oxygen, then send it back into the heart through the left atrium, where it is pumped into the left ventricle and out into our body. Whew! Quite a complicated process, huh? Each heartbeat involves precise choreography to work perfectly — and normally functioning hearts do it approximately 100,000 times per day!

During atrial fibrillation, the atria of the heart contract irregularly and chaotically, decreasing blood flow into the ventricles. Think of the heart as the drummer in a band. Normally, the drummer maintains a steady, consistent rhythm that guides the rest of the band. This is the heart's normal rhythm: it beats in a regular, organized way to pump blood efficiently. In atrial fibrillation, however, it's as if the drummer suddenly starts playing completely offbeat. The rhythm becomes unpredictable, and the music stops making sense.

When we experience AFib, we may become dizzy or feel like our heart is fluttering or racing. Some people sweat or start feeling anxious due to their chest discomfort and the interrupted blood flow to the parts of our brain that regulate our moods. Plus, heart palpitations can be scary!

AFib happens in episodes that can be frequent or rare. Typically, these episodes resolve on their own, but sometimes they require a hospital visit to stabilize the rhythm. Untreated, AFib can strain the heart and lead to more serious cardiac problems.

AFib is not to be confused with ventricular fibrillation (VFib), an arrhythmia that requires immediate emergency care. In VFib, the ventricles are not pumping blood into the lungs or body. While AFib is associated with increased risk for certain medical conditions, it is not immediately life-threatening.

Complications of AFib

The most common complications of AFib are stroke and heart attack. Both of these come from the increased risk of clots among those who experience AFib.

Normal, healthy clots move through the body to the places they’re needed to help heal injury and disease. Unneeded clots are broken down and the components are recycled for other uses. However, sometimes the clots don’t go where they should. When we’re sedentary, sitting for long periods during work or travel, our blood pools, causing clots to accumulate instead of moving around. Eventually, they can clump together and make larger clots that our body may not be able to break down as easily. This puts us at risk for problems in risky areas such as arteries narrowed by cholesterol deposits or the tiny blood vessels in the brain, heart, and lungs.

In AFib, blood isn’t being properly pumped out of the heart, so it pools in the atria. Clots clump up and form larger clots, which are then passed through the bloodstream and into the lungs, brain, limbs, or other parts of the heart. This is why people with AFib are at increased risk of problems like stroke and heart attack. The best way for those with AFib to stay safe is to adjust their lifestyle to reduce their risk of clots. This includes eating a healthy diet, managing their weight, quitting or cutting back on drinking, and sometimes using medications to manage clotting and heart rhythm.

In addition to clotting, AFib can cause brain damage due to inadequate blood flow. This can lead to cognitive dysfunction, dizziness, poor coordination, and confusion. Since alcohol can cause similar issues in the brain, it’s particularly risky to drink with an AFib diagnosis, and especially during an AFib episode. When we drink while the heart is in AFib, these effects can amplify each other and lead to more serious problems or injuries.

How Does Alcohol Affect the Heart?

Alcohol is a central nervous system depressant, but there’s more to the story. It stimulates the release of dopamine — the feel-good chemical — in the brain, activating our reward centers and reinforcing our desire to drink. That’s why we feel happy at first when we drink alcohol, and it’s why we end up craving it with regular use. It also stimulates the release of stress hormones like adrenaline, which increases our heart rate and blood pressure. That’s one of the biggest reasons why many people experience a rapid heart rate or heart palpitations after drinking.

In addition to the chemical changes it causes in our bodies, alcohol is a diuretic, meaning it stimulates urine production. This affects our hydration levels and decreases our electrolytes, which are necessary for the heart to produce normal electrical signals. Sodium plays a special role in heart rhythm and needs to be carefully managed when caring for heart conditions like AFib.

These short-term effects of alcohol use tend to resolve fairly quickly. But over time, repeated strain on the heart from alcohol can lead to permanent damage such as cardiomyopathy and chronic conditions like heart failure. Regular alcohol use, including in small amounts, has also been linked to an increased risk of AFib.

Can I Drink Alcohol With Atrial Fibrillation?

In a 2021 study, participants diagnosed with AFib wore heart rate monitors and tracked their alcohol intake. The results showed that drinking alcohol doubles the likelihood of an AFib episode for the next four hours. The evidence is pretty clear: mixing alcohol and AFib does not make for a tasty cocktail. For those who have already been diagnosed with AFib, drinking alcohol leads to worsening of symptoms and an increased risk of complications. For those who haven’t been diagnosed, alcohol increases the chance of developing AFib.

Alcohol use is associated with a broad range of health problems affecting every system of the body. Beyond the heart risks, alcohol damages the stomach, kidneys, bones, teeth, gut, liver, and more. Since all these body parts are connected through the cardiovascular system, it’s important to prioritize heart health to avoid further damage to them, especially if we already have a risky heart condition like AFib. When we mix alcohol and AFib, we put every part of our body at risk.

Does Alcohol Interact With Blood Thinners?

In addition to the physical risks, alcohol interacts with many medications used to treat AFib and its symptoms.

Blood thinners are commonly prescribed to treat AFib. They work by modifying the behavior of platelets, which are small fragments of blood cells that clump together to form clots.

There are two main categories of blood thinners.

• Antiplatelets, like aspirin. These work by preventing activation and accumulation of platelets.
• Anticoagulants, like heparin and warfarin. These work by making platelets less “sticky.”

So, is alcohol a blood thinner? Sort of. Alcohol has both antiplatelet and anticoagulant properties, meaning it can increase the effects of both of these types of medications. While some studies show that small amounts of alcohol may be safe, the truth is that even a single drink per day is associated with an increased risk of side effects.

People on blood thinners are at increased risk of bleeding. Excessive alcohol use is associated with bleeding in the stomach and esophagus, potentially worsening these conditions. In addition, drinking inhibits coordination and balance, putting us at greater risk for falls and other injuries, which become significantly more dangerous when our blood doesn’t clot properly.  

Mixing alcohol with other AFib medications like calcium channel blockers and beta blockers can lead to dangerously low blood pressure levels and should be avoided.

Risks of Drinking With AFib

• Low blood pressure. Alcohol lowers blood pressure, which can cause dizziness and issues with coordination. This amplifies similar symptoms caused by AFib.
• Heart damage. AFib puts extra stress on heart muscles, and so does alcohol. Together, they strain on your heart, which can lead to more serious issues like heart failure, cardiomyopathy, or heart attack.
• Excessive bleeding. Alcohol has blood-thinning properties. If you’re taking blood thinners to treat or prevent complications of AFib, you could be increasing your risk of complications or side effects from your medication.
• Increase in AFib episodes. Since alcohol puts so much strain on the heart, you’re more likely to experience an AFib episode or exacerbate an ongoing episode. Each time this happens, you’re at a greater risk of complications like stroke or heart attack.
• Medication interactions. Besides blood thinners, most other medications used to treat AFib have some sort of interaction with alcohol, from mild to severe. When taking medication to manage AFib, it’s best to just avoid alcohol.

Not Worth the Risk

An occasional drink may seem harmless when we have a condition like AFib, which doesn’t seem to impact us every single day. But the truth is, it increases the risk of serious complications and makes it more likely that AFib becomes a regular part of our life. AFib and alcohol use cause many of the same symptoms, and they can lead to similar chronic conditions. The heart, one of the most fundamental and essential parts of our body, is incredibly sensitive to how we treat it. Heart disease is the leading cause of death globally, causing nearly 700,000 deaths in the U.S. alone in 2021. The number two cause of death globally is stroke, a known complication of AFib. We can take control of AFib through medications, lifestyle changes, and by quitting or cutting back on drinking alcohol and by reducing complicating factors that worsen outcomes of AFib.