Alcohol and Arrhythmias

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. (J Am Coll Cardiol EP 2023;9:266-279) (c) 2023 by the American College of Cardiology Foundation.

Automated summary

The association between alcohol consumption and abnormalities of heart rate and rhythm has been well recognized. Attention has been focused on the risk of atrial fibrillation (AF) and sudden cardiac death (SCD) with excessive alcohol intake. Recent studies have enhanced our understanding of these relationships and provided insights into potential arrhythmogenic mechanisms. However, there is still considerable uncertainty regarding the level of consumption that causes harm and the role of alcohol in other arrhythmias. This review examines the spectrum of conduction abnormalities and heart rhythm disorders in relation to alcohol consumption, and 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.