Holiday Heart Syndrome: Prevention and Treatment

The last month of the year is full of holiday parties, stress, and extra opportunities to have a few drinks — and that can have a huge impact on your heart.

Holiday heart syndrome is a term used to describe irregular heartbeat and, in some cases, atrial fibrillation (afib) that is specifically associated with binge drinking, a common occurrence during the holidays.

According to Rakesh Gopinathannair, MD, a cardiac electrophysiologist with the Kansas City Heart Rhythm Institute in Missouri, holiday heart syndrome typically occurs in people who do not have existing heart disease, though whether someone develops new onset atrial fibrillation depends on a lot of factors.

“Afib is the most common heart rhythm disturbance, and high blood pressure, sleep apnea, and being 65 or older all factor in to whether or not a particular person who is drinking heavily will get these particular rhythm issues,” says Dr. Gopinathannair. He adds that that it isn’t clear how common holiday heart syndrome is since many people who experience the condition often don’t see a doctor.

One thing that is clear: Heavy alcohol consumption, even on just one occasion, can trigger atrial fibrillation, a condition that’s been on the rise for decades, according to the Centers for Disease Control and Prevention (CDC). By 2030, more than 12 million Americans are expected to experience afib, the CDC estimates.

Alcohol Consumption Inflames the Heart, Increasing the Risk of New Onset Atrial Fibrillation

According to the Substance Abuse and Mental Health Services Administration, binge drinking at least five days in a month is considered heavy drinking, and nearly 45 percent of current alcohol users in the United States are binge drinkers. Nearly 13 percent are heavy alcohol users. Different amounts of alcohol count as binge drinking for different people, but the CDC defines binge drinking as five or more alcoholic beverages in two hours for men and four for women.

But even one or two drinks will raise a person's blood alcohol level, which can impact the heart’s natural rhythm and increase the risk of holiday heart syndrome.

A study published in November 2021 in the Annals of Internal Medicine, which included 100 participants, mostly white men with an average age of 64, found a strong correlation between even moderate alcohol use and atrial fibrillation. The researchers found that an afib event was associated with twofold higher odds of having consumed at least one drink in the four hours preceding the event and a more than threefold higher chance of having consumed at least two drinks in that time frame.

Another study, published in November 2021 in JAMA Cardiology, compared factors that were thought to trigger afib, including caffeine consumption, sleep deprivation, dehydration, eating large meals, exercise, laying on the left side, and drinking alcohol. Researchers found that alcohol consumption was the only one that significantly increased a person’s risk for afib.

According to Kristen Brown, MD, a cardiovascular fellow at the University of Nebraska Medical Center in Omaha, alcohol inflames the lining of the heart and irritates tissue. The chemicals in alcohol alter chemicals in tissue, which interferes with the organ’s normal electrical rhythms.

What Does Holiday Heart Syndrome Feel Like?

According to the CDC, symptoms of afib can include irregular heartbeat, heart palpitations, lightheadedness, extreme fatigue, shortness of breath, and chest pain. According to Gopinathannair, during afib, a person’s heart rate tends to be quite fast, between 150 and 200 beats per minute.

“But symptoms can also go unnoticed and then lead to a big heart event later on,” says Dr. Brown.

“During afib, blood is turbulent in the heart, and when that happens, the blood is more likely to clot,” says Brown. “If a clot develops in the left side of the heart, it can travel to the brain, limbs, or organs and cause an ischemic stroke.”

For this reason, some people who present with holiday heart syndrome (which your healthcare provider may diagnose as alcohol-induced atrial arrhythmias) may be put on blood thinners, Brown says, adding that one episode of atrial fibrillation puts you at a higher risk for recurrent afib, which then puts you at a higher risk for heart failure.

Long-Term Effects of Atrial Fibrillation

A study published in February 2020 in the journal Circulation found that recurrent atrial fibrillation is closely tied to heart failure, stroke, and death, and that alcohol consumption increased a person’s chances of having recurrent afib. While some people have genetic predispositions that put them at risk for a first afib event, alcohol intake is one of the risk factors that people do have control over, says Brown.

The treatment for holiday heart syndrome starts with stopping alcohol consumption immediately, says Gopinathannair.

“Once you abstain from alcohol, basically treatment would be hydration and get electrolytes. The majority of the cases of atrial fibrillation, during holiday heart syndrome stop on their own, but there is always the risk of future episodes,” he says.

To Lower Your Risk of Holiday Heart Syndrome, Avoid Binge Drinking

Because drinking is so embedded in American culture, the general population often doesn’t recognize the true effect that alcohol intake has on the body, says Brown. That's especially true for people with underlying heart disease.

The simplest way to avoid holiday heart syndrome is to limit your holiday drinking. The CDC recommends no more than one drink a day for women and two for men on days when alcohol is consumed, which shouldn’t be every day. But even staying within those limits may increase the risk of dying from certain cancers and cardiac disease, the CDC says.

Brown says, “People aren’t going to completely give up drinking, but excessive amounts of alcohol can have big effects on the brain, kidneys, and heart." To put your best holiday heart forward, she says, "the main lesson here is just to limit alcohol use.”

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