Alcohol consumption and risk of atrial fibrillation

Despite well-established evidence linking alcohol consumption to an increased risk of atrial fibrillation (AF), a clear threshold for safe intake remains undefined. Most clinical guidelines recommend abstinence or moderation but lack specificity regarding quantitative limits and evidence-based thresholds for the primary prevention of AF. Researchers reviewed and combined results from multiple studies to assess whether different levels of alcohol consumption affect the risk of developing AF.

Participants were grouped by typical daily intake: no intake, very low (<12 g/day), low (12. 1-24 g/day), moderate (24. 1-48 g/day), high (48. 1-60 g/day), and very high (>60 g/day). The researchers compared the risk of AF in each drinking group with the risk in people who did not drink alcohol. They also used advanced statistical methods to synthesise data across studies and compare all drinking levels simultaneously. Overall, they estimated how alcohol consumption influenced the likelihood of developing AF and examined whether the relationship differed between men and women.
Twenty-six studies with nearly 15 million participants were included. Compared with people who did not drink alcohol, those who consumed very high amounts had a 75% higher risk of developing AF. In contrast, people who drank less than 48 grams of alcohol per day generally had a slightly lower risk of AF, with the lowest risk seen among those who drank less than 12 grams per day.
Participants were followed for an average of about 6.4 years. Additional analyses that combined and compared all levels of alcohol consumption supported these findings, showing that very heavy drinkers had a significantly higher risk of AF than those who drank low, moderate, or high amounts. Similar patterns were observed in both men and women.
Alcohol consumption is associated with a nonlinear, threshold-dependent relationship with incident AF. While low-to-moderate intake may not increase AF risk, intake beyond 60 g/day significantly increases AF risk. These findings suggest that a more liberal approach to alcohol consumption, particularly at low-to-moderate levels, may be reasonable in the general population, although further prospective studies are needed to confirm causality and refine individual risk stratification.
Source: Asad, Z.U.A., Jafry, A.H., Akbar, U., Beard, C., Khan, J.A., Krishan, S. et al. (2026). Alcohol consumption and risk of atrial fibrillation: a pairwise and network meta-analysis, EP Europace, euag111,