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Arrhythmias and the “Holiday Heart”: Alcoholassociated cardiac rhythm disorders

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Abstract

An association between excessive alcohol use and cardiac rhythm disorders is often difficult to establish in the absence of overt cardiomyopathy. We studied 32 separate hospital admissions for dysrhythmias in 24 patients (20 men, 4 women) with heavy recent alcohol ingestion and prolonged excessive alcohol use. None had evidence of overt heart disease after treatment of arrhythmia. Episodes usually followed heavy weekend or holiday sprees, resulting in hospitalization between Sunday and Tuesday or in proximity to the year-end holidays, a relationship not observed in other alcohol-associated illnesses. Atrial fibrillation was most common, but atrial flutter, atrial tachycardia, junctional tachycardia, multiple APC's, multiple PVC's and ventricular tachycardia were also observed. Transient hypokalemia was present in four of 30. The mean PEPLVET ratio after treatment was 0.412 ± 0.014 (normal 0.299 ± 0.008, P < 0.001). High-speed ECG's showed prolongation of PRc, QRS, and QTc. At cardiac catheterization, intracardiac pressures and volumes, coronary arteriograms and ventricular wall motion were normal at rest and mean cardiac index was slightly low, but the left ventricular response to angiotensin was abnormal. Cardiac arrhythmias presenting during weekend or holiday drinking episodes are associated with conduction delays and depressed cardiac performance indicative of early cardiomyopathy and suggest a “holiday heart” syndrome.

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    This research was supported in part by Research Grant No. AA00242 from the National Institute of Alcohol Abuse and Alcoholism and Postgraduate Training Grant No. HL 05510 from the National Heart and Lung Institute, and Research Grant No. 75-BER-1 from the Bergen County Heart Association, New Jersey Affiliate-American Heart Association.

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