Some people with atrial fibrillation say it feels like their heart could flop out of their chests. Others feel like they’re about to pass out. And still others feel nothing at all.

Atrial fibrillation (A-fib) is the most common form of heart arrhythmia, or irregular heartbeat, affecting 2.7-6.1 million people in the United States, according to the Centers for Disease Control and Prevention (CDC).

Although A-fib disorders may appear with a variety of symptoms, they all have the same cause – irregular and rapid beating of the upper chambers of the heart.

Episodes of A-fib can be unsettling and uncomfortable, but are not generally life-threatening. However, if untreated, A-fib can lead to dangerous health conditions.

People with A-fib are around five times more likely to have a stroke than people without the condition, and strokes can lead to permanent disability or death.

A-fib can weaken the heart muscle over time, which triples the risk of heart failure. Risk of dementia doubles also.

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Alcohol may have both positive and negative effects on the heart according to studies.

The overall impact of alcohol on the heart is the subject of ongoing discussion in the medical community.

Researchers have found it can have both positive and negative impacts on the heart.

The positive effects of alcohol, associated with moderate drinking only, include:

  • raising levels of the “good” cholesterol, HDL
  • preventing platelets from forming blood clots
  • reducing the buildup of plaque in the circulatory system

The following negative effects of alcohol on the heart are usually associated with heavy drinking:

According to the American Heart Association, although caffeine has many effects on the human body, at present no links have been confirmed between caffeine intake and heart disease.

In addition, studies have not found a link between caffeine and arrhythmia. However, reports indicate that drinking more than 5 cups of coffee each day can raise blood pressure.

Are alcohol and caffeine triggers that can cause A-fib?

Many health experts believe there is a connection between caffeine, alcohol, and A-fib, and that either substance can trigger an attack. However, researchers are still investigating the specific causes.

Many factors identified as possible triggers for A-fib may work alone or together to cause the condition. This makes it difficult to establish what is or is not a trigger.

As a result, it is also hard to work out how much coffee or alcohol could trigger an episode of A-fib.

Alcohol is a known trigger for a specific form of A-fib known as holiday heart syndrome (HHS). HHS is the sudden appearance of A-fib in individuals who are otherwise healthy, but who recently took part in binge drinking. The Centers for Disease Control and Prevention (CDC) define binge drinking as more than five drinks for men and four drinks for women in a 2-hour period.

Researchers have noticed these cases are more frequent after weekends and holidays linked with increased alcohol use, which is how HHS got its name.

In addition, some studies have found a connection between the risk of A-fib and chronic, alcohol use. A connection was not found for moderate drinkers.

A 2005 study exploring caffeine use in Scandinavia did not find any connection between A-fib and caffeine use.

The scientific community is divided on whether or not people with A-fib can consume alcohol or caffeine safely.

The American Heart Association advise individuals with A-fib to avoid excessive amounts of alcohol and caffeine.

However, a report published in the Journal of the American College of Cardiology found that even moderate use of alcohol increased the risk of A-fib. The risk rose by around 8 percent with each additional drink taken per day.

A third study found that two drinks each day for women did not increase the risk of A-fib, but three or more did. Another study found that the risk did not increase for men until they had more than five drinks per day.

There is some concern among experts regarding energy drinks. This is due to the high level of caffeine they contain and observed increases in the heart’s contraction rate. Healthy young adults could tolerate this increase, but it could be a problem for children and those with pre-existing heart conditions.

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It is recommended that consumption of both caffeine and alcohol is moderate.

Even with the potential heart health benefits of moderate drinking, medical authorities generally do not advise anyone to start drinking alcohol solely to protect their hearts.

For those who do drink alcohol, the link between A-fib and alcohol use seems most apparent with chronic heavy drinking and binge drinking, and not with moderate drinking. The problem lies in defining “moderate” drinking.

StopAfib.org recommend following the general heart health guidelines, which set limits of one drink per day for women and two drinks per day for men.

According to the American Heart Association, a drink is 12 ounces of beer, 4 ounces of wine, or 1.5 ounces of hard liquor.

The upper limit of safe, daily caffeine use, recommended by the Food and Drug Administration (FDA), is between four and five cups of coffee, or 400 milligrams (mg) of caffeine. Drinking between one and two cups of coffee per day seems to be safe, according to the American Heart Association.

Other risk factors for A-fib

Interestingly, people with A-fib report that the same activities, such as going for a walk, might prompt an attack one day and not the next.

Additionally, heart disease is a known risk factor for A-fib, as are age, obesity, and genetics, hyperthyroidism, diabetes, chronic kidney disease, and European ancestry.

However, there is a closer connection between obstructive sleep apnea and A-fib than any other risk factor.

A list of further potential A-fib causes includes:

  • certain medical procedures
  • emotional stress
  • physical stress
  • dehydration
  • sleep
  • hormones
  • exercise

Some more dietary factors to consider

Following a heart-healthy diet can help people with A-fib. Alcohol can be a part of that, if used in moderation, as can caffeine.

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A heart-healthy diet may include a variety of fruits, vegetables, and whole grains.

The basic elements of a heart-healthy diet include:

  • eating a variety of fruits, vegetables, and whole grains
  • varying protein sources by eating legumes and simply prepared fish and poultry
  • increasing intake of omega-3 fatty acids by eating fish like salmon, herring, or trout
  • reducing sodium use to 2,400 mg per day, or less
  • avoiding saturated fats and the foods that contain them
  • limiting oil in general, selecting healthier oils like olive oil when using them, and avoiding tropical oils
  • avoiding beverages with added sugars
  • not smoking and avoiding secondhand smoke

Exercising regularly is essential for supporting a healthy heart function. A very basic level of activity for heart health, as recommended by the American Heart Association, is:

  • 30 minutes of moderate aerobic exercise 5 days a week
  • muscle-strengthening activities at least twice a week

People are encouraged to work with their healthcare providers to develop an appropriate exercise plan.