The level of acute alcohol exposure during binge drinking associates with the extent of cardiac response

The cardiovascular effects of acute alcohol exposure remain incompletely understood, despite its reported association with arrhythmias such as atrial fibrillation (AF). The Munich-BREW II study supported a link between excessive alcohol consumption, increased heart rate, impaired heart rate variability (HRV), and a higher incidence of arrhythmias. Academics present sub-analyses exploring how the amount of alcohol consumed during binge drinking and the maximum breath alcohol concentration (BAC) influence these findings.
The Munich-BREW II study is a prospective, single-centre cohort study conducted at LMU University Hospital, Munich from October 2016 to July 2017. Participants consumed alcohol under supervision, with hourly BAC measurements and continuous 3-lead Holter monitoring for ECG analyses of heart rate, HRV, and arrhythmias. Subgroup analyses stratified participants by quartiles of alcohol consumption and peak BAC, respectively.
The research analysed 193 participants (mean age 29.9 ± 10.6 years, 36% women). Subgroup analyses revealed that higher alcohol intake during binge drinking was associated with significantly increased heart rate and reduced HRV measures. Similarly, higher BAC levels correlated with elevated heart rates. Both subgroups showed a more marked effect in the highest quartile. Clinically relevant arrhythmias were not differently distributed across subgroups.
In this subgroup analysis of the Munich-BREW II study, higher alcohol consumption and BAC during binge drinking were linked to increased heart rate and reduced cardiac autonomic tone. The findings indicate a dose-response relationship and discourage excessive alcohol intake. Further research is needed to explore how varying levels of alcohol exposure can influence clinical outcomes.
Source: von Falkenhausen AS, Krewitz C, Winter R, Kern A, Brunner D, Brunner S, & Sinner MF. (2025) The level of acute alcohol exposure during binge drinking associates with the extent of cardiac response. Clinical and Research Cardiology.