Alcohol May Trigger Dangerous Palpitations in Atrial Fibrillation Patients
No clear associations between age as a trigger, but study group was small; problem named ‘holiday heart syndrome’ in 1978
June 1, 2012 — A new study of a clinical group with an average age of 59 builds a stronger link between alcohol consumption
and serious heart palpitations in patients with atrial fibrillation, the most common form of arrhythmia. A study in 1978 first discovered such
patients experiencing a common and potentially dangerous palpitation after excessive drinking.
The term “holiday heart syndrome” was coined after tje 1978 study since excessive drinking is common during the winter
holiday season. The symptoms usually went away when the revelers stopped drinking.
Now, research from UCSF builds on that finding, establishing a stronger causal link between alcohol consumption and
serious palpitations in patients with atrial fibrillation, the most common form of arrhythmia.
In a paper scheduled to be published August 1 in the American Journal of Cardiology, the University of California,
San Francisco (UCSF) researchers report that people with atrial fibrillation had almost a four and a half times greater chance of having an
episode if they were consuming alcohol than if they were not.
“One of the remaining big unknowns is why or how this happens,” said senior author Gregory Marcus, MD, assistant
professor of medicine at the UCSF Division of Cardiology.
“In a previous publication, we suggested that there was an effect on the electrical activity of the atrium that leads to
these arrhythmias but we do need additional studies to prove that.”
Alcohol and Heart Palpitations
In the study, conducted from September 2004 to March 2011, UCSF researchers interviewed 223 patients with documented
cardiac arrhythmia, a term that encompasses both atrial fibrillation and supraventricular tachycardia (SVT), or rapid heart rate originating
above the ventricles.
Researchers asked patients, “Does alcohol trigger your heart palpitations?” Participants ranked their symptoms on a
scale from one to five (i.e. never, rarely, sometimes, frequently, and always).
“We defined ‘yes’ as frequently or always versus the rest of the responses,” Marcus said, “and found that, after
adjusting for potential confounders, atrial fibrillation patients had statistically significant greater odds of reporting that alcohol would
trigger their symptoms.”
Of those patients interviewed, 133 reported intermittent or paroxysmal atrial fibrillation, or irregular heart
palpitations, when drinking, and 90 had SVT, without any atrial fibrillation.
After adjusting for variables, the paroxysmal atrial fibrillation group had a 4.42 greater chance of reporting alcohol
consumption as an arrhythmia trigger, compared to the SVT group. Patients’ claims of atrial fibrillation were verified by surface
electrocardiograms and invasive cardiac studies.
The mean age of the study participants was 59 years. Eighty percent were Caucasian; 11 percent were Asian; 5 percent
Latino, and 4 percent declined to state their ethnicity in the atrial fibrillation group. All were referred to and studied at UCSF.
“We didn’t find any clear associations between age and race as a trigger, but we probably had insufficient number of
people in the study,” Marcus said.
Studying the Effects of Alcohol
Other studies have suggested that alcohol could help decrease the chance of developing atherosclerosis, which clogs or
narrows the arteries. One of the proposed sources of benefit is the antioxidant in red wine called resveratrol, which may help prevent heart
disease by increasing the “good” cholesterol in a person’s body.
“There may be some beneficial effects to alcohol, but it’s important to look at actual heart outcomes, like stroke and
death,” Marcus said. “Keep in mind that we used to think estrogen was good for your heart based on observational studies, and now we know
that’s not exactly true.”
He says there’s insufficient information at this time to recommend any lifestyle changes related to alcohol and heart
disease risk. Still he points out that this report and previous reports indicate alcohol can cause cardiomyopathy and worsen hypertension.
“If someone has heart palpitations or atrial fibrillation, I’m often asked, ‘Can I drink at all?’” Marcus said. “And I
don’t know the answer, but it may be that certain people are susceptible.
“The clinical evidence suggests that some people are susceptible and other people aren’t, but if they know that they’re
susceptible they should avoid alcohol,” he said.
Co-authors are Mala Mandyam; Vasanth Vedantham, MD, PhD; Melvin Scheinman, MD; Zian Tseng, MD, MAS; Nitish Badhwar, MBBS;
Byron Lee, MD, MAS; Randall Lee, MD, PhD; Edward Gerstenfeld, MD; and Jeffrey Olgin, MD, all of the UCSF Division of Cardiology,
This study was supported by the National Center for Research Resources, the National Center for Advancing Translational
Sciences, and the Office of the Director, National Institutes of Health, through UCSF-CTSI Grant Number TL1 RR024129. Its contents are solely
the responsibility of the authors and do not necessarily represent the official views of the NIH.
UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level
education in the life sciences and health professions, and excellence in patient care.
Doctors diagnose AF using family and medical history, a physical
exam, and a test called an electrocardiogram (EKG), which looks at the electrical waves
your heart makes. Treatments include medicines and procedures to restore normal rhythm.
A standard drink is equal to 13.7 grams (0.6 ounces) of pure alcohol. Generally, this amount of pure alcohol is found in
> 12-ounces of beer.
> 8-ounces of malt liquor.
> 5-ounces of wine.
> 1.5-ounces or a “shot” of 80-proof distilled spirits or liquor (e.g., gin, rum, vodka, or whiskey).
● Is beer or wine safer to drink than liquor?
No. One 12-ounce beer has about the same amount of alcohol as one 5-ounce glass of wine, or 1.5-ounce shot of liquor. It
is the amount of alcohol consumed that affects a person most, not the type of alcoholic drink.
● What does moderate drinking mean?
There is no one definition of moderate drinking, but generally the term is used to describe a lower-risk pattern of drinking. According to the
Dietary Guidelines for Americans,1 drinking in moderation is defined as having
no more than 1 drink per day for women and no more than 2 drinks per day for men. This definition is referring to the amount consumed on any
single day and is not intended as an average over several days.
Research grows saying what we eat, drink impacts dementia
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