During the holiday season—or weddings, graduations, or other occasions—when more alcohol than usual is often consumed, it is common for otherwise healthy young people to develop episodes ofatrial fibrillation.
This article discusses atrial fibrillation, its causes, and its association with alcohol consumption.
Atrial Fibrillation and Holiday Heart Syndrome
Atrial fibrillation is a fairly common heart rhythm disturbance that often producessignificant symptoms, especially easy fatiguability andpalpitations. For some people, holiday heart syndrome may feel like the heart is racing, while others may feel tired, short of breath, or no energy. The real reason that atrial fibrillation is of concern, however, is that it can lead tostroke.
In most cases, the atrial fibrillation that occurs with holiday heart is “paroxysmal,” meaning that the arrhythmia begins very suddenly and, after some time, stops equally as suddenly. People who have episodes of paroxysmal atrial fibrillation commonly experience symptoms of quite sudden onset, often including:
Symptoms of holiday heart syndrome can last anywhere from 12 to 24 hours.
Verywell / Michela Buttignol
Atrial fibrillation is shown to be the cause when anECGis recorded during one of these episodes.
However, in many other people with the usual forms of atrial fibrillation, no cause can be identified.
Alcohol Consumption
We know that chronic, heavy drinking is associated with a form ofdilated cardiomyopathyandheart failure, which, in turn, often leads to chronic atrial fibrillation. So there’s no question that heavy, long-term drinking is bad for the heart.
Other kinds of overindulgence may occur during these binges, including eating a lot of unhealthy foods or taking drugs. While these factors may play a role in developing holiday heart syndrome, the only factor that is virtually always present is alcohol.
This variety of holiday heart—where the atrial fibrillation occurs after an obvious episode of binge drinking—is the most common form of this condition. Doctors are well aware of this more obvious variety and usually make the diagnosis easily.
There is no treatment for this condition other than advising the person to avoid binge drinking in the future.
A More Subtle Atrial Fibrillation
There appears to be a much more subtle form of holiday heart syndrome, one in which atrial fibrillation occurs, but a history of true binge drinking is absent. It turns out that some people are extremely sensitive to alcohol. In these individuals, moderate amounts of alcohol (typically two or three drinks), and sometimes even a single drink, can trigger episodes of atrial fibrillation.
If the association between paroxysmal atrial fibrillation and alcohol ingestion is missed (because there hasn’t been very much alcohol ingestion and no binge drinking), the healthcare provider may be led to recommend chronictherapy for atrial fibrillation. Such treatment can be quite unpleasant or even risky. In fact, the appropriate treatment for this condition is to avoid drinking alcohol.
For someone who has had an episode of holiday heart syndrome after a small amount of alcohol, the recommended treatment is to avoid all alcohol in the future.
This milder form of holiday heart syndrome may be more common than is currently recognized. So, people who have episodes of paroxysmal atrial fibrillation should carefully consider the circumstances in which this arrhythmia has occurred, and try to determine whether it seems to be related in any way to alcohol consumption.
Doctors who treat people with paroxysmal atrial fibrillation should be sure to ask about even minor exposure to alcohol and examine other aspects of the person’s lifestyle since atrial fibrillation is a “lifestyle disease" more often than realized. By making the proper diagnosis, they may avoid recommending inappropriate treatments.
Summary
“Classic” holiday heart syndrome refers to the onset of sudden atrial fibrillation after an obvious bout of binge drinking. In addition, some people will have atrial fibrillation after even very moderate alcohol consumption. It is important for doctors to consider even trivial amounts of alcohol ingestion when trying to figure out why a relatively young, healthy person has developed an episode of atrial fibrillation.
5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.University of Alabama Birmingham.Holiday heart syndrome: What is it? How can you prevent it?National Heart, Lung, and Blood Institute.Atrial fibrillation causes and risk factors.Larsson SC, Drca N, Wolk A.Alcohol consumption and risk of atrial fibrillation: a prospective study and dose-response meta-analysis.J Am Coll Cardiol2014; 64:281. doi: 0.1016/j.jacc.2014.03.048Tonelo D, Providência R, Gonçalves L.Holiday heart syndrome revisited after 34 years. Arq Bras Cardiol. 2013 Aug;101(2):183-9. doi: 10.5935/abc.20130153Butler T, Cowie A, McHale S, et al.Interventions for alcohol cessation in people with atrial fibrillation. Cochrane Database Syst Rev. 2023 Feb 13;2023(2):CD015004. doi: 10.1002/14651858.CD015004Additional ReadingConstantini, O. and Stambler, B. Approach to the Patient with Atrial Fibrillation. In: Management of Cardiac Arrhythmias, Ganz LI and Braunwald E. Eds. Humana Press, Totowa, NJ.Djoussé L, Levy D, Benjamin EJ, et al. Long-term Alcohol Consumption and the Risk of Atrial Fibrillation in the Framingham Study. Am J Cardio 2004; 93:710.Mukamal KJ, Psaty BM, Rautaharju PM, et al. Alcohol Consumption and Risk and Prognosis of Atrial Fibrillation Among Older Adults: the Cardiovascular Health Study. Am Heart J 2007; 153:260.
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.University of Alabama Birmingham.Holiday heart syndrome: What is it? How can you prevent it?National Heart, Lung, and Blood Institute.Atrial fibrillation causes and risk factors.Larsson SC, Drca N, Wolk A.Alcohol consumption and risk of atrial fibrillation: a prospective study and dose-response meta-analysis.J Am Coll Cardiol2014; 64:281. doi: 0.1016/j.jacc.2014.03.048Tonelo D, Providência R, Gonçalves L.Holiday heart syndrome revisited after 34 years. Arq Bras Cardiol. 2013 Aug;101(2):183-9. doi: 10.5935/abc.20130153Butler T, Cowie A, McHale S, et al.Interventions for alcohol cessation in people with atrial fibrillation. Cochrane Database Syst Rev. 2023 Feb 13;2023(2):CD015004. doi: 10.1002/14651858.CD015004Additional ReadingConstantini, O. and Stambler, B. Approach to the Patient with Atrial Fibrillation. In: Management of Cardiac Arrhythmias, Ganz LI and Braunwald E. Eds. Humana Press, Totowa, NJ.Djoussé L, Levy D, Benjamin EJ, et al. Long-term Alcohol Consumption and the Risk of Atrial Fibrillation in the Framingham Study. Am J Cardio 2004; 93:710.Mukamal KJ, Psaty BM, Rautaharju PM, et al. Alcohol Consumption and Risk and Prognosis of Atrial Fibrillation Among Older Adults: the Cardiovascular Health Study. Am Heart J 2007; 153:260.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
University of Alabama Birmingham.Holiday heart syndrome: What is it? How can you prevent it?National Heart, Lung, and Blood Institute.Atrial fibrillation causes and risk factors.Larsson SC, Drca N, Wolk A.Alcohol consumption and risk of atrial fibrillation: a prospective study and dose-response meta-analysis.J Am Coll Cardiol2014; 64:281. doi: 0.1016/j.jacc.2014.03.048Tonelo D, Providência R, Gonçalves L.Holiday heart syndrome revisited after 34 years. Arq Bras Cardiol. 2013 Aug;101(2):183-9. doi: 10.5935/abc.20130153Butler T, Cowie A, McHale S, et al.Interventions for alcohol cessation in people with atrial fibrillation. Cochrane Database Syst Rev. 2023 Feb 13;2023(2):CD015004. doi: 10.1002/14651858.CD015004
University of Alabama Birmingham.Holiday heart syndrome: What is it? How can you prevent it?
National Heart, Lung, and Blood Institute.Atrial fibrillation causes and risk factors.
Larsson SC, Drca N, Wolk A.Alcohol consumption and risk of atrial fibrillation: a prospective study and dose-response meta-analysis.J Am Coll Cardiol2014; 64:281. doi: 0.1016/j.jacc.2014.03.048
Tonelo D, Providência R, Gonçalves L.Holiday heart syndrome revisited after 34 years. Arq Bras Cardiol. 2013 Aug;101(2):183-9. doi: 10.5935/abc.20130153
Butler T, Cowie A, McHale S, et al.Interventions for alcohol cessation in people with atrial fibrillation. Cochrane Database Syst Rev. 2023 Feb 13;2023(2):CD015004. doi: 10.1002/14651858.CD015004
Constantini, O. and Stambler, B. Approach to the Patient with Atrial Fibrillation. In: Management of Cardiac Arrhythmias, Ganz LI and Braunwald E. Eds. Humana Press, Totowa, NJ.Djoussé L, Levy D, Benjamin EJ, et al. Long-term Alcohol Consumption and the Risk of Atrial Fibrillation in the Framingham Study. Am J Cardio 2004; 93:710.Mukamal KJ, Psaty BM, Rautaharju PM, et al. Alcohol Consumption and Risk and Prognosis of Atrial Fibrillation Among Older Adults: the Cardiovascular Health Study. Am Heart J 2007; 153:260.
Constantini, O. and Stambler, B. Approach to the Patient with Atrial Fibrillation. In: Management of Cardiac Arrhythmias, Ganz LI and Braunwald E. Eds. Humana Press, Totowa, NJ.
Djoussé L, Levy D, Benjamin EJ, et al. Long-term Alcohol Consumption and the Risk of Atrial Fibrillation in the Framingham Study. Am J Cardio 2004; 93:710.
Mukamal KJ, Psaty BM, Rautaharju PM, et al. Alcohol Consumption and Risk and Prognosis of Atrial Fibrillation Among Older Adults: the Cardiovascular Health Study. Am Heart J 2007; 153:260.
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