The "Holiday Heart": Electrophysiologic Studies of Alcohol Effects in Alcoholics

Abstract

Although the holiday heart syndrome, highlighted by rhythm disturbances after acute alcohol ingestion, is well known, the potential arrhythmogenic effects of alcohol have not been studied. Fourteen patients (2 with congestive cardiomyopathy) with a history of rhythm disturbances and alcohol consumption were studied electrophysiologically. One patient had nonsustained ventricular tachycardia, 1 had nonsustained atrial fibrillation, 1 had paired ventricular responses and the remainder had no response to the extrastimulus technique. After 90 ml of 80 proof whiskey, 10 of 14 patients developed sustained or nonsustained atrial or ventricular tachyarrhythmias. Significant prolongation of His-ventricular conduction was seen after alcohol intake; this was noteworthy as 1 patient had previously shown Mobitz 2 atrioventricular block after acute alcohol consumption. Alcohol in modest doses had the potential to produce rhythm disturbances in patients with a history of chronic alcohol consumption and heart disease.