Alcohol and Atrial Fibrillation: A Sobering Review

J Am Coll Cardiol. 2016 Dec 13;68(23):2567-2576. doi: 10.1016/j.jacc.2016.08.074.


Alcohol is popular in Western culture, supported by a perception that modest intake is cardioprotective. However, excessive drinking has detrimental implications for cardiovascular disease. Atrial fibrillation (AF) following an alcohol binge or the "holiday heart syndrome" is well characterized. However, more modest levels of alcohol intake on a regular basis may also increase the risk of AF. The pathophysiological mechanisms responsible for the relationship between alcohol and AF may include direct toxicity and alcohol's contribution to obesity, sleep-disordered breathing, and hypertension. We aim to provide a comprehensive review of the epidemiology and pathophysiology by which alcohol may be responsible for AF and determine whether alcohol abstinence is required for patients with AF.

Keywords: atrial flutter; binge drinking; holiday heart syndrome; obesity; obstructive; sleep apnea.

Publication types

  • Review

MeSH terms

  • Alcohol Drinking / adverse effects*
  • Alcohol Drinking / epidemiology
  • Animals
  • Atrial Fibrillation / epidemiology
  • Atrial Fibrillation / etiology*
  • Atrial Fibrillation / physiopathology
  • Electrocardiography
  • Global Health
  • Heart Conduction System / physiopathology*
  • Humans
  • Incidence