Especially during the holiday season, or during weddings, graduation or other occasions for celebration, it is not uncommon for otherwise healthy young individuals to develop episodes of atrial fibrillation - a condition known as Holiday Heart. Some doctors are unaware of the more subtle instances of Holiday Heart, and their puzzlement may lead them to give inappropriate advice, or even start these patients on inappropriate therapy.
Atrial fibrillation is a common heart rhythm disturbance that often produces significant symptoms, and can even lead to stroke. It is a rapid and irregular heart arrhythmia, caused by chaotic electrical impulses in the atria of the heart (the two upper chambers). A comprehensive discussion of atrial fibrillation can be found here.
Most cases of Holiday Heart start as " paroxysmal atrial fibrillation," that is, atrial fibrillation that starts suddenly, and after a time, stops suddenly. Patients will experience the sudden onset of rapid heart rate, palpitations, and often dizziness or shortness of breath. When their doctors do an ECG, they will see atrial fibrillation.
In many cases, atrial fibrillation is caused by underlying heart disease or by aging. Sometimes it has no identifiable cause. But in Holiday Heart, the cause is an unusual sensitivity to alcohol consumption.
Alcohol is known to produce atrial fibrillation if ingested in large quantities, even in "normal" individuals. Up to 60% of patients who engage in heavy binge drinking will develop episodes of atrial fibrillation. This is one form of Holiday Heart, and doctors are generally well aware of this phenomenon.
But some individuals are extremely sensitive to alcohol, such that even moderate amounts - two or three drinks, and sometimes a single drink - can trigger episodes of atrial fibrillation.
Holiday Heart Is Often Overlooked by Doctors
This form of Holiday Heart is much more subtle, and can be easily overlooked by a doctor. If the association between the paroxysmal atrial fibrillation and alcohol ingestion is missed (because there really hasn't been much alcohol ingestion), the doctor may be led to recommending unpleasant or risky therapies - whereas the appropriate therapy is simply to avoid drinking alcohol. Any alcohol.Patients who have episodes of paroxysmal atrial fibrillation should carefully examine whether the episodes seem in any way to be related to alcohol consumption. And doctors who treat patients with this condition should be careful to ask about even minor exposure to alcohol. Making the proper diagnosis may spare the patient from inappropriate treatments.
Source:
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.; 2002.
