Be careful when you lift a glass to toast the season — you might also be increasing your risk for atrial fibrillation, or an irregular heartbeat. 

A study published earlier this year found that even moderate drinking is linked with AFib.

Experts have known for some time that binge drinking — more than four drinks in two hours for women, or five for men — can put you at higher risk for developing AFib. Because binge drinking increases over the holidays, this increase in AFib is sometimes called “holiday heart syndrome.”

And there’s more bad news. A study published earlier this year found that even moderate drinking is linked with AFib. “Alcohol is a pretty potent trigger for AFib,” says John Osborne, MD, a cardiologist in Dallas and spokesperson for the American Heart Association. 

This increased risk is especially troublesome as we age. That’s because risk for AFib already increases as we get older. “More than 25% of us over the course of our lives will have AFib. It’s extremely common,” Osborne says. And sleep apnea, high blood pressure, and obesity — three conditions common in older adults — are also linked with higher risk of AFib.

Stroke risk is a top concern

AFib is concerning because it greatly increases your risk of stroke. “If you have AFib, whether you have it all the time or it comes and goes, you have five times the risk of stroke,” Osborne says. “15% of all strokes are due to AFib, and as you get older that percent increases. For patients in their 80s, about 40% of all strokes are due to AFib.” 

And strokes due to AFib tend to be larger, more disabling, and more likely to be fatal.

You may not notice symptoms

If you have AFib, you might have a rapid heart rate of 130 beats per minute or more, and feel like your heart is racing. In that case you should contact your healthcare provider. If you also have chest pain and shortness of breath, or feel faint, get to an emergency room, since a rapid heart rate could also be linked with other serious health conditions. 

About half of the people with AFib will have an irregular heart rate that stays below 100 beats per minute. “They could be walking around with AFib unaware,” Osborne says. In those cases, healthcare providers sometimes pick up signs of AFib when they are checking pulse rates or blood pressure. An EKG can confirm whether the heart rate is in fact irregular.

Treating AFib and its causes

A lot of different health conditions can cause AFib, including blood clots in the lungs, heart valve problems, and thyroid issues, Osborne says. So your doctor will want to diagnose and, if necessary, treat the underlying cause of the condition.

Your doctor may also prescribe a blood thinning medication like Eliquis, Pradaxa, or Xarelto to reduce your stroke risk, depending on your other risk factors. Aspirin used to be recommended, but it’s not found to reduce the risk of stroke linked with AFib, Osborne says. 

If your AFib comes and goes your doctor can prescribe medications you can take when you notice symptoms that will bring your heart rate back into normal rhythm.

Lifestyle changes can also make a difference. “There are a lot of things we can do beyond medicine. We want to stay height/weight proportionate, use alcohol moderately and cautiously, and stay active,” Osborne says. 

People with AFib may want to consider a home EKG machine, which you can often buy for less than $100. “They can quite effectively tell if you’re in AFib,” Osborne says. “They link to your phone and you can send the data on to your doctor or a cardiologist.” The Apple Watch can also detect signs of AFib.

Once diagnosed, AFib is highly treatable. “We can manage AFib very well and reduce major consequences by 80 to 90%,” Osborne says.