Acute alcohol consumption has long been associated with various cardiac arrhythmias, a phenomenon often referred to as “holiday heart syndrome.” This term describes the occurrence of cardiac arrhythmias, including atrial fibrillation, following episodes of excessive alcohol intake. The specific effects of acute alcohol consumption on the heart, however, remain under-explored. A prospective cohort study, as detailed in Practice Update, sheds light on the temporal progression of cardiac arrhythmias in young adults subsequent to binge drinking episodes.

Study Design and Methodology

This comprehensive study involved 202 volunteers who planned to engage in acute alcohol consumption, with anticipated peak breath alcohol concentrations (BAC) of ≥1.2 g/kg. Participants underwent a 48-hour electrocardiogram (ECG) monitoring across several phases: baseline (hour 0), ‘drinking period’ (hours 1-5), ‘recovery period’ (hours 6-19), and two control periods following the ‘drinking’ and ‘recovery periods’. BAC measurements were taken to monitor acute alcohol intake during the ‘drinking period’. The ECG recordings were analysed for mean heart rate, atrial tachycardia, premature atrial complexes (PACs), premature ventricular complexes (PVCs), and heart rate variability (HRV).

Key Findings on Heart Rate and Arrhythmias

The study revealed a significant increase in heart rate associated with alcohol intake. This was accompanied by an excess of atrial tachycardia events. HRV analyses indicated a modulation of autonomic function, characterised by sympathetic activation during alcohol consumption and the subsequent ‘recovery period’, with a shift towards parasympathetic predominance thereafter. Notably, PACs were more prevalent during the ‘control periods’, while PVCs showed increased frequency during the ‘drinking period’.

Detailed Analysis of Arrhythmic Episodes

Among the participants, ten individuals experienced notable arrhythmic episodes, such as atrial fibrillation and ventricular tachycardias, primarily occurring during the ‘recovery period’. These findings underline the proarrhythmic potential of acute alcohol consumption, emphasising its role in triggering clinically significant arrhythmias.

Implications for Prevention Strategies

The findings enhance the understanding of the proarrhythmic effects of acute alcohol consumption, with important implications for both primary and secondary prevention strategies. By delineating the physiological changes induced by alcohol intake, the study provides insights into potential interventions to mitigate the risks associated with binge drinking.

Source: Practice Update