Written by Dr Ranjan Shetty December 30, 2025 04:51 PM IST 4 min readA recent research on 200 partygoers, who had quite a few drinks, found that they had cardiac arrhythmias (irregular heartbeats) over 48 hours.A 32-year-old young man landed in the emergency on New Year’s Day this year, disoriented and in panic. He had irregular heartbeat or arrhythmia, his heart rate was 200 beats per minute (normal between 60 and 100), he was sweating, gasping and was restless. He was suffering not a heart attack but severe arrhythmia, a consequence of drinking and munching snackables through the night.Now alcohol and food can lead to aspiration, cough, lung distress and gastro-intestinal tract-related discomfort. But a sudden gush of alcohol had upset his heart rhythms. This is what we cardiologists call the holiday heart syndrome, where heavy drinking at a single sitting can cause the heart’s upper chambers or atria to beat irregularly and often faster than normal. This condition is called atrial fibrillation. Heavy alcohol consumption, even on just one occasion, can trigger it. In fact, women are more vulnerable than men in this respect. The good part is that it can settle with medication.Why is alcohol quick to act on the heart?Alcohol is one of the strongest cell toxins that exist. When its concentration goes up in the body, the atria (or the two upper chambers of the heart that receive blood), can’t contract or pump blood properly into your lower chambers or ventricles. Your ventricles may get 140 to 160 signals per minute instead of the normal 60 to 100 per minute. The mismatch of electrical impulses leads to the blood coagulating and forming clots. And sometimes these clots get dislodged, travel to the brain and cause strokes. The heart cannot pump enough oxygenated blood to meet the body’s requirements, a condition we call heart failure. Also, worsening the impact of alcohol on a pub night is eating high-calorie foods.Rapid alcohol intake constricts blood vessels, forcing the heart to pump harder, increasing blood pressure. Chronic binge drinking impacts an existing weak heart muscle, leading to heart failure. Alcohol stimulates stress hormones, constricting vessels and increasing heart rate.How does holiday heart syndrome manifest itself?Irregular heartbeats, palpitations, light-headedness, extreme fatigue, shortness of breath and chest pain. Some patients may even need blood thinners. The symptoms may go away but even one episode of atrial fibrillation can put you at a higher risk for recurrent afib, which then puts you at a higher risk of heart failure and strokes.How to be vigilant about alcohol use?No doctor will recommend a drink but men should not cross two drinks (assuming each drink is 30 ml, this means 60 ml of hard liquor or 24 gram of alcohol) while women should confine themselves to just a single drink. Anything over this amount would qualify as binge-drinking and is directly toxic to the heart muscle and the heart’s conduction system, which basically means the electrical impulses of the heart.I have seen patients who have had 200 gm (roughly 14 glasses) of alcohol one after another with food in a single night. This behaviour is risky.Can a social drinker also get this syndrome?Story continues below this adA body which is not used to alcohol overuse can react to binge drinking suddenly. A recent research on 200 partygoers, who had quite a few drinks, found that they had cardiac arrhythmias (irregular heartbeats) over 48 hours. In an unprepared and seemingly healthy heart, such irregular rhythms may lead to malfunctioning of electrical impulses and the heart stopping suddenly. This is called sudden cardiac arrest (SCA). Consuming too much alcohol at one go damages your heart, stretching, enlarging and, therefore, weakening it. This is called alcohol-induced cardiomyopathy, when the heart cannot pump as well as it should. This reduces your body’s available oxygen supply. This condition can affect anyone who consumes too much alcohol, even those who don’t have alcohol use disorder.How to treat it?The holiday heart syndrome is usually managed with hydration through an IV line, electrolytes, vitamins, anticoagulants to prevent blood clots, beta-blockers or calcium channel blockers to manage your heart rate and medications called antiarrhythmics to control your heart rhythm. Keep to drinking limits on New Year’s eve and stay away if you already have a heart condition.(Dr Shetty is lead cardiologist and medical director, Sparsh hospital, Bengaluru) © The Indian Express Pvt Ltd