Acute alcohol consumption and arrhythmias in young adults: the MunichBREW II study

Abstract

Background and aims: Acute excessive alcohol intake may cause the holiday heart syndrome, characterized by cardiac arrhythmias including atrial fibrillation. Since underlying data are scarce, the study aimed to prospectively investigate the temporal course of occurring cardiac arrhythmias following binge drinking in young adults.

Methods: A total of 202 volunteers planning acute alcohol consumption with expected peak breath alcohol concentrations (BACs) of ≥1.2 g/kg were enrolled. The study comprised 48 h electrocardiogram monitoring covering baseline (Hour 0), 'drinking period' (Hours 1-5), 'recovery period' (Hours 6-19), and two control periods corresponding to 24 h after the 'drinking' and 'recovery periods', respectively. Acute alcohol intake was monitored by BAC measurements during the 'drinking period'. Electrocardiograms were analysed for mean heart rate, atrial tachycardia, premature atrial complexes, premature ventricular complexes (PVCs), and heart rate variability measures.

Results: Data revealed an increase in heart rate and an excess of atrial tachycardias with increasing alcohol intake. Heart rate variability analysis indicated an autonomic modulation with sympathetic activation during alcohol consumption and the subsequent 'recovery period', followed by parasympathetic predominance thereafter. Premature atrial complexes occurred significantly more frequently in the 'control periods', whereas PVCs were more frequent in the 'drinking period'. Ten participants experienced notable arrhythmic episodes, including atrial fibrillation and ventricular tachycardias, primarily during the 'recovery period'.

Conclusions: The study demonstrates the impact of binge drinking on heart rate alterations and increased atrial tachycardias during 'drinking period', and the occurrence of clinically relevant arrhythmias during the 'recovery period', emphasizing the holiday heart syndrome as a health concern.

Keywords: Alcohol; Arrhythmia; Atrial fibrillation; Autonomic nervous system; Electrocardiogram; Holiday heart syndrome.