- Binge drinking (≥5 drinks/2 hours) consistently triggered AF across studies up to n=400,000.
- AF onset typically occurred within 24 hours, with a second window at 12–36 hours.
- Physiologic changes: sympathetic surges, shortened atrial refractory periods, reduced vagal tone.
- Transient reduction in left atrial emptying fraction occurred without structural damage.
- Whiskey and beer posed higher AF risk; women drinking spirits had greater susceptibility.
- Mechanisms included acetaldehyde-driven catecholamine release, electrolyte loss, sodium-channel inhibition.
- AF usually resolved with abstinence; recurrence followed renewed heavy intake.
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