Holiday Heart Syndrome: How seasonal celebrating can trigger heart rhythm issues

The holidays are a time for gathering with loved ones, sharing meals and raising a glass (or two) in celebration. But for some, indulging a little too much can trigger heart palpitations—potentially coupled with dizziness and shortness of breath—the morning after the festivities. This not-so-merry condition, rightfully dubbed Holiday Heart Syndrome, is when the body experiences temporary atrial fibrillation as a direct result of binge drinking.

According to Steven Kutalek, MD, a cardiac electrophysiologist at Trinity Health Mid-Atlantic Medical Group’s Electrophysiology Langhorne (plus the Darby, Holme and Cottman locations), Holiday Heart Syndrome typically occurs in healthy individuals.

“Holiday Heart Syndrome happens in folks who have electrically and mechanically normal hearts and valves, no coronary disease. They are not big drinkers—they just happened to binge drink one night, especially around the holidays, which are a time to celebrate,” says Dr. Kutalek. “They have these drinks and the next morning when they wake up, their hearts are pounding away and they’re in atrial fibrillation. They may feel lightheaded or dizzy because they’re probably also dehydrated. And if they check their heart rate, it could be anywhere from 130 to 160 beats a minute.”

While Holiday Heart Syndrome can be caused by alcohol alone, mixing an excess of drinks with heavy foods and caffeine has the capacity to amplify symptoms. However, alcohol is the main culprit because of its cardiotoxic nature, meaning it has a toxic effect on the cells of the heart.

“This doesn’t mean long-term damage, which happens when you drink regularly. But short-term effects include the alteration of the electrical system of the heart, which can trigger the arrhythmia,” says Dr. Kutalek. “It doesn’t take a lot.”

Oftentimes, Holiday Heart Syndrome is temporary and resolves on its own within a day after the onset of symptoms—especially in younger individuals (under age 50) with no history of coronary disease or underlying conditions. But for older patients with comorbidities, Holiday Heart Syndrome comes with a high risk of stroke.

“Atrial fibrillation increases the risk of stroke because the atrium is not contracting properly and blood stagnates in it. So, if someone comes in with atrial fibrillation because they’ve been drinking a lot and they’re 66 years old with a history of high blood pressure and diabetes, that increases their risk of stroke,” says Dr. Kutalek. “That patient may need to be put on an anticoagulant or blood thinner, even if it’s only for a few months.”

Oftentimes, Holiday Heart Syndrome is temporary and resolves on its own within a day after the onset of symptoms—especially in younger individuals (under age 50) with no history of coronary disease or underlying conditions. But for older patients with comorbidities, Holiday Heart Syndrome comes with a high risk of stroke.

For those younger folks who experience Holiday Heart Syndrome, it is usually a one-off, isolated event and they shouldn’t require immediate medical attention, unless their symptoms are truly debilitating. However, it’s still recommended that they contact their provider soon to be safe. A primary care doctor can refer them to a cardiac electrophysiologist, which is a type of cardiologist who specializes in arrhythmia care.

“They should have an assessment by a cardiologist just to be sure there’s no structural heart disease that might have triggered this,” says Dr. Kutalek. “It’s good to make a diagnosis. It could be Holiday Heart Syndrome or it may be something else. After the weekend or holiday is over, make an appointment to get checked out. You want to be sure there’s no underlying cardiac disease or even just subtle valvular disease. For example, someone may have high blood pressure they haven’t recognized before.”

As Christmas and New Year’s fast approach, Dr. Kutalek wants people to know that they can partake in the festivities and protect their heart at the same time. The key, he says, is moderation.

“Don’t overeat and stuff yourself. Don’t drink to excess. Keep hydrated because dehydration is not going to make you feel good the next morning. And don’t combine high dose alcohol with a high dose of caffeine that night,” says Dr. Kutalek.

Visit Heart and Vascular Care for more information and to schedule an appointment.