Fast Five Quiz: Holiday Heart Syndrome

Yasmine S. Ali, MD


December 01, 2021

Given the generally transient nature of alcohol-induced AF in the structurally normal heart, rate control and supportive care for alcohol intoxication is generally adequate. For rate control, treatment with an atrioventricular nodal blocking agent (eg, beta-blocker, calcium channel blocker) may be needed if the ventricular rate is rapid. Digoxin is a third-line option; chronic therapy with this drug is rarely indicated. If the duration of AF approaches 24-48 hours, cardioversion (pharmacologic or electrical) may be considered once the patient is medically optimized and the alcohol withdrawal period is complete.

Although long-term anticoagulation is indicated for patients with paroxysmal, persistent, or permanent AF plus risk factors for stroke or systemic thromboembolism, caution should be used in patients with acute alcohol toxicity. Unless high-risk features are present (ie, prior stroke, mechanical heart valve, other indication for anticoagulation), a reasonable approach may be to allow the patient to recover from the acute episode and then initiate anticoagulation once they are clinically stable.

Learn more about the treatment of holiday heart syndrome.

This Fast Five Quiz was excerpted and adapted from the Medscape Drugs & Diseases article Holiday Heart Syndrome.

Follow Medscape on Facebook, Twitter, Instagram, and YouTube


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.