6 Surprising Lifestyle Triggers of Cardiac Arrhythmia, According to Cardiologists

1. Weight

The top lifestyle trigger, according to cardiologist Dr. Aman, is weight. “Obesity is closely linked with atrial fibrillation,” he explains, noting that excess body weight can place added strain on the heart, increase blood pressure, and promote structural changes in the heart’s upper chambers.

Research published in Arrhythmia & Electrophysiology Review confirms that obesity not only raises the risk of developing atrial fibrillation, but can also make episodes more frequent and harder to control. Even modest weight loss—around 10% of body weight—has been associated with significant reductions in AFib symptoms and improved heart rhythm stability.

2. Alcohol (even in small amounts)

Many people think only heavy drinking affects the heart, but Dr. Ayoub notes that even small amounts of alcohol can trigger cardiac arrhythmia symptoms, particularly in those already prone to irregular heartbeats. Alcohol interferes with the heart’s electrical signaling, making abnormal rhythms more likely. The link is so well recognized that researchers coined the term “holiday heart syndrome” to describe episodes of atrial fibrillation that occur after moderate or binge drinking, often during weekends or special occasions like the holiday season.

A 2020 study published in The New England Journal of Medicine found that abstaining from alcohol significantly reduced arrhythmia recurrences in regular drinkers with atrial fibrillation. Alcohol can also disrupt sleep, dehydrate the body, and interfere with medications—all of which further increase arrhythmia risk.

3. Poor sleep and sleep apnea

Tossing and turning at night might seem harmless, but chronic poor sleep—or an undiagnosed case of obstructive sleep apnea (OSA)—can take a serious toll on your heart rhythm. According to Dr. Aman, obstructive sleep apnea is “hugely underdiagnosed,” yet it has a direct connection to atrial fibrillation.

“In fact, when someone is newly diagnosed with AFib, I often recommend a sleep study, cutting back on alcohol, and working on weight loss,” he says. “We’ve seen that people feel significantly better and can sometimes even reverse their arrhythmias with those changes.”

Obstructive sleep apnea causes repeated pauses in breathing during sleep, leading to drops in oxygen levels and surges in blood pressure that can strain the heart. Identifying and treating sleep apnea, through CPAP therapy, weight loss, or other interventions, can dramatically improve symptoms and lower the risk of arrhythmia recurrence.

4. Caffeine and energy drinks

Many people rely on coffee or energy drinks to power through the day, but if you have—or are at risk for—a heart rhythm condition, that extra boost could be doing more harm than good. Dr. Ayoub notes that caffeine and energy drinks are a lifestyle trigger for cardiac arrhythmia, particularly when consumed in excess.

While moderate caffeine intake, such as one or two cups of coffee a day, is generally safe for most people, high doses, especially from energy drinks, have been linked to heart rhythm disturbances. A 2021 review published in Frontiers in Cardiovascular Medicine found that energy drinks, which often combine caffeine with stimulants like taurine and guarana, have been associated with supraventricular arrhythmias and QT interval prolongation, a marker for serious heart rhythm risks.

If you experience palpitations, chest fluttering, or dizziness after drinking caffeinated beverages, it may be a sign your heart isn’t tolerating the stimulation. People with a known arrhythmia or cardiovascular risk factors should consider limiting caffeine and avoiding energy drinks entirely, while talking with their doctor about what’s safe for them.

5. Over-the-counter decongestants

Reaching for an allergy or cold remedy may seem harmless, but some over-the-counter decongestants can actually trigger heart rhythm issues, especially in people who are sensitive to stimulants or have preexisting heart conditions. Dr. Ayoub identifies these medications as a surprising but significant arrhythmia trigger.

Many common decongestants, such as pseudoephedrine—a stimulant found in popular products such as Sudafed, Claritin-D, and Zyrtec-D—work by narrowing blood vessels to reduce nasal swelling. According to Harvard Health, this same vasoconstriction can raise blood pressure and speed up heart rate.

If you notice your heart racing or feeling irregular after taking a cold medication, stop using it and speak to your healthcare provider. Safer alternatives may be available, especially if you have a history of arrhythmias or cardiovascular disease.

6. Electrolyte imbalances (low potassium or magnesium)

You don’t have to be severely ill or hospitalized to experience an electrolyte imbalance. When levels of key minerals such as potassium and magnesium dip too low, your heart may feel the impact. According to Dr. Ayoub, electrolyte imbalances are a lifestyle trigger of cardiac arrhythmia, especially in people who are dieting, overexercising, or taking certain medications.

Potassium and magnesium help regulate the electrical impulses that keep your heartbeat steady. When these levels drop—due to dehydration, diuretics, poor diet, or even heavy sweating—it can disrupt the heart’s rhythm and lead to palpitations, skipped beats, or more serious arrhythmias.

Is cardiac arrhythmia dangerous?

“Some arrhythmias are benign,” says Dr. Ayoub, meaning they are generally harmless, don’t cause lasting damage, and may not require treatment. However, “others can be dangerous or life-threatening.”

For example, atrial fibrillation and atrial flutter can significantly increase the risk of stroke, while ventricular tachycardia may lead to sudden cardiac death if left untreated. That’s why it’s so important to take new or worsening cardiac arrhythmia symptoms seriously, especially if you feel faint, short of breath, or experience chest discomfort.

The good news: with the right diagnosis and treatment, most arrhythmias can be managed safely. If you’re concerned about your heart rhythm, schedule an appointment with your doctor or a cardiologist to discuss your symptoms and potential next steps.

How to prevent cardiac arrhythmia

While some arrhythmias are unpredictable, many can be prevented—or better managed—through targeted lifestyle changes. Here are some of the top strategies Dr. Ayoub and Dr. Aman recommend to help prevent or manage cardiac arrhythmia symptoms:

• Get quality sleep and treat any underlying sleep apnea
• Reduce caffeine and alcohol intake
• Stay well hydrated and maintain healthy electrolyte levels
• Avoid over-the-counter stimulants, energy drinks, and smoking
• Exercise regularly to support heart health
• Maintain a healthy weight

Modern technology can also play a role in early detection. “Devices like Apple Watch and KardiaMobile can detect AFib or irregular rhythms and are especially helpful when symptoms are intermittent,” Dr. Ayoub says.

These tools are improving over time. “Initial studies showed they were only about 50% accurate, but I believe that’s improved,” says Dr. Aman. He also notes that many patients come to his clinic because their Apple Watch or another device picked up an irregular heartbeat. “While they’re not 100% accurate, they do prompt people to get checked. That’s a good thing.”

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