If I drink, when should I go see my cardiologist about it?

Three situations require a cardiologist visit, not a Google search: if your Apple Watch, Kardia, or similar ECG-capable wearable has flagged irregular rhythm or possible atrial fibrillation on a drinking night, that is not a situation to dismiss; if you experience palpitations, fluttering in the chest, or a racing heart on drinking nights, these are symptoms of transient AFib or alcohol-triggered arrhythmias that deserve clinical documentation; and if you have a known AFib diagnosis and are still drinking regularly, the AFib-alcohol dose-response is additive to your existing recurrence risk and the conversation with your cardiologist should already have happened.

Blood pressure responses to alcohol are worth checking at home: measure your blood pressure the morning after two drinks and compare it to non-drinking mornings. If your systolic is consistently 8–10 mmHg higher after drinking, that is a direct cardiovascular signal worth discussing. Men who drink above 14 units per week and have persistently elevated home blood pressure have an identifiable and addressable contributor to their hypertension that belongs in the clinical conversation. (Larsson et al., BMJ, 2014)

Cardiologist's calibrated position, Solid (1) for seeking evaluation on wearable-detected rhythm abnormalities related to drinking.

What to do: Document palpitations with time of occurrence and quantity consumed. Bring this log to your cardiologist. A 48-hour Holter monitor or 14-day event monitor during a period of normal drinking gives direct evidence about alcohol's effect on your cardiac rhythm.

For the full picture, read The Bourbon Collector's Honest Reckoning.