Related Experiment Videos
Cardiac arrest following holiday heart syndrome
1Department of Physiology, University of The Andes, Mérida, Venezuela. farocha@ing.ula.ve.
Insights
Binge drinking can trigger dangerous heart rhythms like ventricular fibrillation, often linked to underlying dual atrioventricular nodal pathways. Radiofrequency ablation successfully treated a patient with holiday heart syndrome, preventing recurrence after alcohol cessation.
Area of Science:
- Cardiology
- Electrophysiology
- Toxicology
Background:
- Holiday Heart Syndrome (HHS) is characterized by cardiac arrhythmias precipitated by excessive alcohol consumption.
- Understanding the electrophysiological substrate of HHS is crucial for effective management.
Observation:
- A patient presented with ventricular fibrillation following alcohol binge, successfully resuscitated.
- Electrophysiological study revealed dual atrioventricular nodal pathways and inducible atrial fibrillation with rapid ventricular response causing hemodynamic collapse.
Findings:
- Dual atrioventricular nodal pathways and rapid ventricular response in atrial fibrillation were identified as key contributors to ventricular fibrillation.
- Radiofrequency ablation of the atrioventricular node modified the electrophysiological substrate, preventing recurrence.
Implications:
- This case highlights the importance of identifying underlying electrophysiological abnormalities in patients with alcohol-induced arrhythmias.
- Alcohol cessation combined with targeted electrophysiological intervention can effectively manage Holiday Heart Syndrome and prevent life-threatening events.
Abstract:
We describe the case of a patient who, after a binge, had an episode of ventricular fibrillation (holiday heart syndrome) and was successfully resuscitated. In the electrophysiological study, we found dual atrioventricular nodal pathways, an atrioventricular effective refractory period of 210 ms, and an inducible atrial fibrillation with a ventricular response of 210 bpm that produced hemodynamic collapse. Atrioventricular nodal modification by radiofrequency ablation was successfully performed. The patient stopped drinking alcohol and has remained completely asymptomatic. In this case, ventricular fibrillation was probably caused by the fibrillating atria combined with a fast AV node.