“Can I drink alcohol with heart palpitations?”

I'd recommend taking a break from drinking alcohol and consulting with your medical provider.

No, you should not drink alcohol if you are experiencing palpitations. Alcohol is known to adversely affect the cardiac electrical conduction system. The mechanisms arent important. What is important is that binge drinking, in particular, can cause atrial fibrillation, even in younger patients. Its called the Holiday Heart syndrome. Atrial fibrillation comes with its potential complications, including thromboembolic CVAs. The thrombus, blood clot, that form in the left atrial appendage can leave the heart and travel up the carotid arteries to the middle cerebral artery. Eventually they obstruct the small arterioles and capillaries in the temporal- parietal lobes, leading to strokes that can paralyze one side of the body. ( hemiparesis) and affect speech permanently (Aphasia). Atrial fibrillation also causes sustained rapid heart rates or tachycardia, with ventricular rates as high as 150-180 bpm. The myocardium (heart muscle) can not sustain normal systolic function (contraction) if these rates persist for more than a couple of days. This can lead to tachycardic-induced cardiomyopathy and congestive heart failure. Atrial fibrillation is not the most common cause of palpitations. Most palpitations are related to premature ventricular contractions or PVCs, extra strong beats originating from electrically excitable myocardial cells in the ventricles. Alcohol can cause PVCs or exacerbate pre-existing ectopic beats from either chamber, including premature atrial contractions orPACs. To diagnose the cause we generally have the patient get an ecg in clinic then check electrolytes levels. If necessary they can wear a monitor for several days. The root cause is often malfunction of the autonomic nervous system and elevated levels of neurohormones, such as norepinephrine (an adrenaline analog). Alcohol will aggravate this type of automaticity and hyper excitable tissue. The treatment is usually beta blocker therapy (metoprolol) for most causes of palpitations. These drugs slow down heart rate and contractility and relax the excitable foci in the myocardial tissue. But avoidance of stimulants ( Sudafed, diet pills ADD meds, excessive caffeine), alcohol , and offending prescription drugs ( albuterol inhalers, steroids) are a necessary part of treatment.