EN
The situation is familiar to almost everyone: after a long evening of drinking the heart pounds and stumbles, and sleep is impossible. By the next evening it has usually passed and is forgotten. German cardiologists set out to find what actually happens to the heart rhythm of healthy people during and after serious drinking — and chose perhaps the most suitable place in the country for it.
What was found at the Oktoberfest
Researchers from Ludwig Maximilian University in Munich and the German Centre for Cardiovascular Research (DZHK) brought their equipment straight to the Oktoberfest of 2015. Over three thousand volunteers agreed to an ECG taken with a smartphone-based portable device and, at the same time, a breath alcohol test. The work appeared in the European Heart Journal in 2017 and is known as MunichBREW.
Rhythm disturbances were found in roughly a third of the participants — noticeably more often than they are usually found in people in calm surroundings. The overwhelming majority of the abnormalities were sinus tachycardia: the rhythm regular, simply much faster. And the higher the alcohol concentration in the breath, the more often abnormalities were recorded. The authors also looked separately at data from the large KORA population study in the Augsburg region: an association with habitual daily intake could be traced too, but it was appreciably weaker than the association with a single excess.
What the following years added
The main question was left open at the time. The ECG was taken once, and what happened to the person afterwards the authors honestly admitted they did not know. Whether it passes with the hangover or sets off something more serious could not be said.
The sequel — MunichBREW II, published in the same journal in 2024 — was arranged differently. Around two hundred volunteers wore an ECG monitor for two days running: before drinking, during and after. It turned out that the most notable episodes of arrhythmia, including short runs of atrial fibrillation, fell not at the peak of intoxication but in the recovery phase — when the person is already sobering up and asleep.
Data of another kind accumulated alongside. An Australian randomised trial published in the New England Journal of Medicine in 2020 showed that in people who already have atrial fibrillation, giving up alcohol reduces the number of rhythm disturbances. The American HOLIDAY study demonstrated that alcohol directly changes the electrical properties of the atrial tissue, and that the effect lasts for several hours after drinking.
By 2024 this had ceased to be the subject of isolated papers and entered the guidelines. In the European Society of Cardiology guideline on atrial fibrillation, limiting alcohol — to roughly three standard drinks a week — stands alongside control of blood pressure, weight and sleep apnoea, that is, among the measures discussed with every patient.
What follows from this for the individual
If your heart is healthy and the palpitations after a celebration passed within a few hours, this is most likely the very temporary episode the Munich researchers described. But if a diagnosis of atrial fibrillation has already been made, alcohol is one of the few provoking factors you can influence yourself, without medication or procedures.
Pay particular attention if the irregularity lasts longer than a day, is accompanied by breathlessness, chest pain, dizziness or fainting, or recurs after every occasion of drinking. That is a reason to have an ECG and sometimes 24-hour monitoring — an ordinary single tracing often fails to catch short episodes of atrial fibrillation.
What these data do not yet mean
None of these studies proved that one glass of wine “causes” atrial fibrillation in a healthy person. What is at issue is a statistical association and doses far removed from a single glass: at the Oktoberfest some participants reached very high blood alcohol concentrations. Nor has the opposite been proved — that moderate drinking is a matter of indifference to the heart rhythm: no threshold below which there is definitely no effect has yet been established. And finally, a fast heartbeat after alcohol is not in itself heart disease; it is a reason to check, not a reason for a diagnosis.
This material is for information only and does not replace a consultation with a doctor. Whether an examination or treatment is possible, what it will involve and what it will achieve can be determined only after an examination in person.