Reducing alcohol intake may help some people with atrial fibrillation (AFib), a common irregular heart rhythm. An Australian randomized clinical trial found that regular drinkers with AFib experienced fewer recurrences when they sharply reduced their drinking.

Important: AFib can increase stroke risk and requires individual medical care. Do not change prescribed medication or treatment based on this article. Discuss alcohol use and any symptoms with a qualified clinician.

What the trial examined

The study enrolled 140 adults with AFib who drank at least 10 standard drinks each week. Their average age was 62. Researchers randomly assigned participants either to substantially reduce or avoid alcohol, or to continue their usual alcohol consumption.

Not everyone in the reduction group stopped completely. On average, however, that group lowered consumption from about 17 drinks a week to approximately two. The comparison group reduced its intake only modestly.

What researchers found

During six months of follow-up, AFib recurred in 37 of 70 participants in the alcohol-reduction group and 51 of 70 in the comparison group. People who cut back also went longer before their first recurrence and spent less time in AFib.

Read the result in context

  • The trial was relatively small and lasted six months.
  • Most participants were men, limiting conclusions about other populations.
  • Participants already drank regularly, so the findings do not show that nondrinkers should begin drinking.
  • The study addressed recurrence and AFib burden, not every possible cardiovascular outcome.

The trial had originally been planned for a longer period, but recruitment proved difficult because many potential participants were unwilling to commit to abstinence. Longer and more diverse studies can help clarify how durable the benefit is and whom it helps most.

What this may mean for you

If you have AFib and drink alcohol regularly, ask your clinician whether reducing or avoiding alcohol belongs in your management plan. The appropriate advice depends on your drinking pattern, medicines, other health conditions and risk of withdrawal.

Alcohol guidance has also evolved since this trial was published. Drinking less generally carries less health risk than drinking more, and no amount of alcohol should be treated as necessary for heart health. A clinician can help you interpret general guidance in light of your circumstances.

Plan a safer conversation

Be candid about the number and size of drinks you consume. A “standard drink” may be smaller than a typical home pour or restaurant serving. Ask how alcohol could interact with your rhythm, blood pressure, sleep, anticoagulants and other medicines.

If you drink heavily or experience shaking, sweating, nausea, anxiety or other symptoms when you stop, do not attempt abrupt withdrawal alone. Withdrawal can be dangerous; seek prompt medical guidance.

Everyday steps that can help

For people advised to reduce alcohol, practical measures include keeping track of drinks, choosing alcohol-free days, removing alcohol from the home and planning nonalcoholic options before social events. Support from a clinician or appropriate treatment service may be especially important when cutting back is difficult.

Alcohol reduction is only one possible part of AFib care. Continue prescribed treatment and ask about other relevant factors, such as blood pressure, sleep apnea, activity, weight management and smoking. Learn more about stroke risk, AFib and anticoagulants, and caffeine and abnormal heart rhythms.