Alcohol and Arrhythmias

JACC Clin Electrophysiol. 2023 Feb;9(2):266-279. doi: 10.1016/j.jacep.2022.10.023.


The association between alcohol consumption and abnormalities of heart rate and rhythm has long been recognized. Significant attention has focused on the risk of atrial fibrillation (AF) and sudden cardiac death (SCD) with excessive alcohol intake. Recent studies have advanced our understanding of these relationships and provided additional insights into potentially arrhythmogenic mechanisms. However, considerable uncertainty remains, such as the level of consumption at which harm begins and whether alcohol plays a role in other arrhythmias. This review characterizes the spectrum of conduction abnormalities and heart rhythm disorders in relation to alcohol consumption. In addition, it discusses the latest epidemiologic and experimental evidence, the potential importance of beverage type and constituent ingredients, and conflicting information on drink definitions, thresholds, and recommendations.

Keywords: alcohol; atrial fibrillation; bradyarrhythmias; conduction disease; sudden cardiac death; ventricular arrhythmias.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Alcohol Drinking
  • Atrial Fibrillation*
  • Death, Sudden, Cardiac
  • Ethanol*
  • Heart Rate
  • Humans


  • Ethanol