As a cardiac electrophysiologist, I often work with patients to identify triggers that may be contributing to their atrial fibrillation (AF). While most people are aware of alcohol, caffeine and stress as common culprits, there’s a lesser-known trigger that’s come up more than once in my clinic: cold drinks.

My Experience of Patients with “Cold Drink Heart”

One of my patients, who’d previously had dramatically reduced symptoms after ablation for AF, came back after experiencing a single recurrence. What stood out was that he clearly recalled drinking a very cold beverage just before the episode began. This wasn’t the first time I’d heard this. Other patients, too, have described a similar link.

So when I saw a new study recently published in the Journal of Cardiac Electrophysiology investigating this exact phenomenon nicknamed “Cold Drink Heart” it caught my attention.

What Is ‘Cold Drink Heart’?

‘Cold Drink Heart’ refers to a pattern where patients with AF notice their episodes are consistently triggered shortly after ingesting very cold drinks or food. For some, the connection is so strong that it’s their only recognised trigger.

This isn’t just anecdotal anymore. Research is starting to uncover that cold ingestion may, for a small group of people, provoke AF episodes.

What the Research Says

1. 2025 Study on Cold Drink-Triggered AF (CDH)

A recent study published in the Journal of Cardiac Electrophysiology (2025) investigated over 100 patients who reported this phenomenon. Here’s what they found:

  • 51.5% of patients reported that their AF only occurred after consuming cold drinks or food.
  • The onset was often rapid, sometimes within minutes.
  • Many of these episodes occurred after physical exertion.
  • Avoidance of cold ingestion significantly reduced or eliminated AF in 86.4% of patients.
  • Physician awareness was low, with over half saying their symptoms had been dismissed by at least one healthcare provider.

This study highlights just how under-recognised this trigger is, even among clinicians.

2. 2019 UCSF Survey of AF Patients

An earlier, larger survey conducted by UCSF and published in Heart Rhythm in 2019 asked 957 patients with paroxysmal AF to identify their personal triggers.

  • 7.5% reported that cold drinks triggered their AF.
  • 5% reported the same with cold food.

You can read the full study here.

While that’s a minority, it’s still significant, especially if you’re one of those affected.

Why Might Cold Drinks Trigger AF?

The mechanism isn’t fully understood, but one theory involves the vagus nerve, which plays a role in regulating heart rhythm. Cold ingestion may stimulate this nerve, particularly around the oesophagus and digestive tract, potentially triggering an arrhythmia in people who are already vulnerable.

There may also be a link between post-exercise vagal tone and increased sensitivity to cold ingestion.

What Should You Do If You Suspect Cold Drinks Trigger Your AF?

If you’ve noticed a pattern between cold drinks and AF episodes, here are some tips:

  • Track your symptoms: Keep a diary noting what you consumed and when the episode started.
  • Try a short period of avoidance: See if cutting out very cold drinks or foods reduces your episodes.
  • Be cautious after exertion: This seems to be a common co-factor.
  • Speak to a specialist: Don’t ignore symptoms or feel dismissed. AF is highly individual, and your triggers matter.

Frequently Asked Questions

Can cold water cause heart palpitations?

In some people, yes. It’s not universal, but up to 7.5% of AF patients in one study reported cold drinks as a clear trigger.

Should I stop drinking cold drinks altogether?

Not necessarily. In the majority of patients, cold drinks don’t seem to have any effect on AF. But if you’re noticing a connection, it’s worth trying to reduce or avoid them to see if it helps.

Will this go away with treatment?

It might. If we successfully treat the underlying electrical issues in your heart, through procedures like catheter ablation, you may find that these triggers become less relevant or disappear altogether.

When to Seek Help

If you’re experiencing recurrent AF, especially with unusual or hard-to-pinpoint triggers, it’s worth speaking to a specialist. Understanding your individual pattern is key to creating an effective treatment plan.

👨‍⚕️ Need help managing your AF or understanding your triggers?

I’m a cardiac electrophysiologist specialising in the treatment of atrial fibrillation. If you’re looking for a personalised approach to managing your AF, please consider booking in!

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