My Heart Says No, My Wine Cellar Says Otherwise

This article is a little off my usual topic (relationships) and very personal, but I decided to write it because I have struggled to find any meaningful advice on this topic, and whilst this is not medical advice or recommendations, it is a personal experience shared, and that’s one of the benefits of an online community.

I have atrial fibrillation - AFib, for short. Eight years ago, I had a catheter ablation and, afterwards, abstained from alcohol for 12 months. Recently, I had another episode and needed a cardioversion to get my heart back into a regular rhythm. For those who have never had one, cardioversion is where they put you to sleep and shock the heart back into rhythm. Think ER, but less glamorous and with fewer attractive doctors running down corridors.

After that, my doctor advised me to abstain from alcohol because I’m in a higher-risk category for another AFib episode. Alcohol is not the only factor, of course. AFib can be influenced by genetics, poor sleep, obesity, smoking, chronic stress, diabetes, high blood pressure, sleep apnoea, and sometimes a frustrating combination of the above. But alcohol is one of the levers I can actually pull - which is inconvenient, because I happen to love wine.

And here is my problem: I am passionate about wine. I’m a wine educator, I run wine events, and I have a wine collection that gives me genuine joy. Being told, “You can no longer drink alcohol,” did not feel like being handed a sensible lifestyle recommendation. It felt like someone had walked into one of the most enjoyable corners of my life and switched the lights off.

So what does this mean? For me, complete abstinence may be the safest option on paper, but emotionally and practically it has not felt simple. This is not medical advice. This is a personal opinion piece - my attempt to make sense of the research, my cardiologist’s advice, and the reality of living with AFib while still wanting a life that feels enjoyable, social, and human.

I have scoured the internet, read studies, spoken to doctors, and yes, consulted ChatGPT. What I found was plenty of clear warnings, but not much that felt useful for someone like me - someone who understands the risk, respects it, but is also trying to figure out what a realistic and responsible version of life might look like.

Let me start with the uncomfortable truth. The World Health Organization has said there is no level of alcohol consumption that can be considered completely safe for health. Alcohol contains ethanol, a toxic and psychoactive substance, and the WHO has highlighted its links with cancer and other diseases. That sounds brutal, but it matters. It also matters for AFib. Alcohol can interfere with the electrical activity of the heart, increase blood pressure, disturb sleep, and increase the likelihood of arrhythmia in some people.

The research on AFib and alcohol is not just theoretical. One Australian study looked at regular drinkers with paroxysmal or persistent AFib who were consuming 10 or more standard drinks a week. Those assigned to abstain reduced their drinking dramatically - from around 17 drinks a week to about two - and had fewer AFib recurrences over six months than those who continued drinking. AFib returned in 53% of the abstinence group compared with 73% of the control group. That is not a small difference. Other studies have found that higher alcohol intake is associated with higher AFib risk, although the exact “safe” threshold is still debated and may vary between people.

So let me be very clear: if you follow the safest cardiology advice, complete abstinence is the cleanest answer. If your cardiologist tells you to stop drinking, listen to your cardiologist. This is my journey, not a recommendation. I am not suggesting anyone follow what I am choosing to do. I am saying that if you are like me - conflicted, informed, a little stubborn, and trying to find a way through - this is what I have learned so far.

Let’s start with monitoring. If I am going to continue to drink at all after an AFib diagnosis, I want to know what it is doing to my body. That means monitoring sleep, heart rhythm, heart rate, and blood pressure. I use a proper blood pressure cuff and record my blood pressure morning and evening. I also use devices that can take an ECG, and I check my rhythm regularly. Between my Kardia device, Apple Watch, my Whoop band, and a sleep app, I can see what is happening in my body. For someone with AFib, that matters. If I see a pattern - higher resting heart rate, worse sleep, higher blood pressure, odd rhythm readings - I treat that as my body voting against alcohol.

Spirits are the first thing I have taken off the table. I love a martini. In fact, my martini order often struck terror into waiters and bartenders: extra-dry, half vodka, half gin, stirred, not shaken, olive in, twist in the air. I even used to keep batch martinis in the freezer for emergencies, celebrations, Tuesdays - any occasion really. But spirits contain a high concentration of alcohol, and for me that feels like the wrong kind of efficiency. They can spike heart rate, raise blood pressure, and interfere with sleep. All of those are bad news in AFib world. So, for me, no more spirits.

There are, of course, spirit alternatives: non-alcoholic gin, rum, bourbon, tequila and so on. Most of them are, frankly, disappointing. They can feel thin, weak, and vaguely botanical in a way that suggests someone once waved a juniper berry near a bottle of water. But they are improving, and there are ways to make them work. If I’m making a cocktail - and I mean a cocktail, not a sugary fruit smoothie in a fancy glass - I freeze the non-alcoholic spirit into ice cubes and blend it. That way I don’t dilute something that already needs all the help it can get. I also add a few drops of bitters for depth. Yes, bitters usually contain alcohol, but the amount is tiny; that is a personal compromise I’m comfortable with. Ginger, chilli, ginger bitters, balsamic vinegar or apple cider vinegar can also add heat, grip and tartness - the things alcohol normally brings to the party.

Citrus-based cocktails seem to work particularly well - things like a rum sour or a margarita. I make a very good non-alcoholic margarita with chilli, and it is almost as good as the real thing. Almost. Giving up or reducing alcohol does not mean giving up the ritual of a beautiful drink. My advice, if you are exploring this world, is to become your own mixologist. One afternoon I pulled out all my non-alcoholic spirits and made about 20 versions of classic cocktails. I made some terrible drinks, a few surprisingly good ones, and invented a couple that will make it into my alcohol free cocktail book – when I write it. But it was fun, and it taught me how to build flavour without leaning on alcohol. One unexpected upside is my “Nospresso Martini”: espresso, non-alcoholic rum and non-alcoholic coffee liqueur. It feels naughty and indulgent, and I can drink it at 8 am without guilt or making poor life choices.

Now let’s talk wine. I love wine. I am a wine educator. I own bottles from Mount Etna, the Rhône Valley, Central Otago and other places that make my heart flutter for reasons unrelated to arrhythmia. I am not pretending this part is easy. At the moment, I have limited myself to three glasses of wine per week, with no more than two glasses in one sitting, spread over several hours. I drink slowly, drink water alongside it, and I am now only drinking very good wine. That part, I admit, is a bonus. My wine budget has shifted from “wines for the week” to “wines for the month”. If I only get three glasses, they had better be worth it.

A Coravin has also become my friend. It lets me pour a glass without committing to the whole bottle, which is useful when restraint is now part of the drinking experience. I also pay attention to timing. I do not drink wine within three hours of going to bed, because alcohol and sleep are not friends, even if they pretend to be at first.

As a wine educator, I am very familiar with the sip-and-spit method. At a serious tasting, there may be 30, 40, even 50 wines to evaluate. If you swallowed every sip, by the end of the day you would not be educating anyone. You would be incoherent and under the table. Spitting is normal in the wine world. It lets you enjoy aroma, texture, acidity, tannin, balance and finish without consuming the full amount of alcohol.

Is it alcohol-free? Not completely. A small amount of alcohol can be absorbed through the mouth, and a little can be swallowed accidentally. I have seen estimates around 5% of the alcohol in a tasted-and-spat sample being absorbed or consumed, although this will vary. For context, tiny amounts of naturally occurring ethanol can be found in ripe fruit, fruit juice and bread. That does not make wine tasting risk-free, but for me, sip-and-spit feels like a reasonable way to stay connected to wine while dramatically reducing intake. Your cardiologist may disagree. Mine may raise an eyebrow. Again: this is my calculation, not a rule.

Is it a little weird to spit into a cup next to you at home or in a restaurant? Yes. Absolutely. But you get used to it. I use a stainless-steel water bottle and do it as discreetly as possible. Most people do not notice, and the people close to you adjust quickly. The sip-and-spit method has allowed me to keep enjoying the aromas, flavours and intellectual pleasure of wine without making every wine experience a drinking session.

Now let’s talk about non-alcoholic wine. Interestingly, when I did my WSET Diploma, my essay was on no- and low-alcohol wines, so I have tried many of them and studied how they are made. In simple terms, most are made like wine and then dealcoholised using methods such as vacuum distillation or spinning cone technology. The problem is that alcohol is not just the thing that makes you tipsy. It carries aroma, gives body, adds texture and helps wine feel complete. Remove it and you often remove the soul of the wine. The result can taste like flat grape juice.

The closest I have come to a decent no-alcohol wine experience is sparkling. Bubbles help. Acidity helps. A little sweetness helps. Still, for someone who truly loves wine, most non-alcoholic wines are disappointing. They may work at a social event, a free-flow brunch, or when you simply want something in a wine glass. But if you care deeply about wine, they often do not quite land. My best trick is to turn them into a spritz: add a little non-alcoholic Aperol, elderflower cordial, soda, citrus peel, herbs, ice — make it its own thing rather than asking it to pretend to be Puligny-Montrachet.

Other drinks are easier. Sake alternatives? I have no idea - if someone knows of one, please tell me. Beer, on the other hand, has come a long way. There are now plenty of non-alcoholic beers that are genuinely decent. I am not much of a beer drinker, but socially a non-alcoholic beer is useful: it looks normal, tastes acceptable, and does not require an explanation. My favourite is Asahi Dry Zero, which is alcohol-free and calorie-free - a rare double win. Kombucha is another option, although it can contain small amounts of ethanol, so check the label if that matters to you. And of course there is always sparkling water, soda, tonic, tea, coffee, or any other drink that does not make your cardiologist sigh.

So here are my final words on the matter. If your cardiologist says you are at high risk of repeated AFib episodes and that you should abstain from alcohol, listen to your cardiologist. They know your history, your heart, your medications and your risk profile. Abstinence is the lowest-risk option, and the research supports the idea that reducing alcohol can reduce AFib recurrence and AFib burden, especially in regular drinkers.

However, if, like me, you are prepared to accept some risk - and it is a risk - these are my current golden rules:

1.        No more spirits.

2.        Wine only, and no more than three glasses per week.

3.        Drink good wine. If it is not worth it, do not waste your allowed intake.

4.        Stay hydrated. I aim for at least one glass of water for every glass of wine, and I drink slowly.

5.        Do not be afraid to sip and spit. It may feel strange at first, but it is an excellent way to taste, evaluate and enjoy wine while dramatically reducing alcohol intake.

6.        Do not drink within three hours of going to bed. Alcohol disrupts sleep and sleep matters enormously for AFib.

7.        Monitor your own data. Blood pressure, sleep, resting heart rate and ECG readings are not perfect, but they can show patterns. If alcohol is clearly pushing your body in the wrong direction, believe the data.

8.        Be honest with yourself. The point is not to find loopholes. The point is to live well, reduce harm, respect the condition, and avoid pretending that alcohol is harmless just because we enjoy it.

I miss the ease of drinking without thinking about it. I miss martinis. I miss saying yes without doing a tiny internal risk assessment. But I also like being in sinus rhythm. I like sleeping well. I like not being in hospital. So this is where I have landed for now: less alcohol, better alcohol, more ritual, more honesty, and a lot more listening to my heart - literally.