Catrina Slavin was driving to work earlier this year when, out of the blue, she was struck by what she feared was a heart attack.
“I was sweating, my heart was pounding – then it seemed to slow down and then start again,” says the mother of two.
She drove straight to her GP surgery, where initial tests suggested she could indeed be having a heart attack and Catrina, 41, was told to go straight to A&E.
There she received an ECG (electrocardiogram), which measures the electrical activity of the heart. This ruled out a heart attack, but there was less reassuring news: Catrina had an irregular heart rhythm.
“I had extra beats where they shouldn’t be,” says the podcaster, who lives in Blantyre, South Lanarkshire.
In an attempt to find out why, and after ruling out an underlying heart condition, the consultant asked Catrina if she drank.
“I answered truthfully that I used to drink heavily and drink a lot of booze, but I stopped doing that years ago,” she says. “He said it could still be affecting my heart rhythm and I could still be recovering even now.”
It may seem like an extraordinary outcome for someone who last drank an alcoholic beverage in 2021, but drinking can cause temporary and long-term cardiac arrhythmias.
Catrina Slavin was driving to work earlier this year when, out of the blue, she was struck by what she feared was a heart attack
In the case of temporary changes, this is known as ‘holiday heart syndrome’ – an irregular rhythm that can occur after a heavy drinking session, usually after holidays.
Arrhythmias are cases in which the heart beats too fast, too slow or irregularly, causing palpitations, dizziness or fatigue. The most common form of irregular heart rhythm is atrial fibrillation (AF), which causes the upper chamber of the heart to vibrate, resulting in a fast and irregular heartbeat. The irregular heartbeat can cause blood to pool in the heart, causing a clot to form.
AF is most common in older people because the heart muscle weakens with age. But a new study has shown that heart rhythm disturbances such as atrial fibrillation can occur in younger people who do not have a pre-existing heart condition as a result of heavy drinking.
In the study, 193 volunteers with an average age of 29 years wore a wearable ECG monitor for 48 hours around the time they started drinking and in the hours afterward. None of them had a heart problem and outside of their ‘binges’ they usually drank an average of 6.8 drinks per week.
About 5 percent of participants developed a heart arrhythmia, especially in the 6- to 19-hour “recovery period” after they stopped drinking, according to results published in October in the European Heart Journal.
One participant, a 26-year-old man, had a significant arrhythmia that lasted for an hour, 13 hours after his last drink.
The researchers from LMU University Hospital in Munich said their results showed that holiday heart syndrome “should be recognized as a relevant health problem” and called for future studies to analyze “why these changes might occur and what the consequences might be” . .
Heavy drinking creates the perfect storm for a rhythm problem, says Dr Simon Modi, cardiologist and heart rhythm specialist at Liverpool Heart and Chest Hospital.
Over time, regular binge drinking can lead to high blood pressure and long-term weakening of the heart muscle, which also increases the chance of developing an irregular heart rhythm.
This is partly because the toxic nature of alcohol has a direct effect on the heart muscle, but it is also due to dehydration after a binge – along with electrolyte imbalance (loss of potassium and magnesium) due to alcohol’s diuretic effect ( meaning you pee more), all of which can happen during and immediately after the binge,” he adds. ‘These all increase the risk of heart rhythm problems because they can affect the electrical activity of the heart.’
If you regularly drink too much, over time it can lead to high blood pressure and long-term weakening of the heart muscle – “which also increases the risk of AF and therefore heart failure and stroke,” says Dr. Modi.
Some people are more at risk of this than others.
‘The more conditions you have that make you more susceptible to cardiac arrhythmias – such as diabetes, obesity, a family history of AF, a previous heart attack or damage to the heart muscle or sleep apnea (where you stop breathing for short periods while you sleep) – the more likely it is is that lower amounts of alcohol will affect your heart,” Dr. Modi explains.
The type of drink can also matter.
‘A recent large study in Australia suggested that wine and spirits can be consumed at very low levels (less than seven drinks per week) without increased risk – but that any consumption of beer and cider increases the risks of AF.’
Dr. Modi says it is not clear why beer and cider are different. ‘Maybe beer and cider drinkers report below how much they drink compared to wine drinkers.’
The good news is that abstaining from alcohol, or dramatically reducing the amount you drink if you’re a heavier drinker, ‘reduces the chance of further episodes of AF or worsening heart problems — so binge drinking in your early 20s , may not always lead to alcohol abuse. long-term cardiac arrhythmia if that habit was curbed,” says Dr. Modi.
Before the episode that landed her in the hospital, Catrina had occasionally suffered from a racing heart after binge eating.
“I could always drink more than anyone else and drank longer,” she says – which could be wine, vodka or spirits. ‘From Monday to Thursday I was the picture of decency, but then I fell off the wagon and drank heavily. I saw it as my end-of-the-week treat, but it had a dark side.”
That dark side regularly woke up in the middle of the night with a rapid heartbeat.
“I started having palpitations that were so strong they woke me from sleep,” she says. ‘I lay there counting and trying to get my heart rate down. It started to happen more and more often after a binge.’
Things got worse for Catrina during the Covid-19 lockdown.
“Working from home meant that the weekdays meant nothing anymore,” she says, and she also started drinking during the week.
In September 2021, Catrina woke up in the early morning hours with the worst palpitations she had ever had.
‘I lay there in bed at home and prayed that I would make it. I thought about my son and daughter, who were only 14 and 15 at the time. What if I died? What if they lost their mother? I knew I had to stop drinking completely.’
Catrina hasn’t had a drink since. But three years after she quit, in January this year, she suffered even worse palpitations while driving to work.
She remembers: ‘By now I was going to the gym, walking and exercising, but the palpitations were exactly the type I had when I was hungover all those times before.’
Her doctor placed a heart rate monitor on her finger and she watched her heart jump from 130 beats per minute to 40, then to 90 and back down again.
“The doctor told me to go to hospital, where a consultant would see me urgently,” says Catrina.
‘I asked if I was having a heart attack and he said tests would confirm this and that I should go as soon as possible.’
At the hospital, the news that she wasn’t having a heart attack was “a huge relief,” she says. ‘But then the consultant looked serious and said I had an ectopic heartbeat – essentially extra beats where they shouldn’t be.’
Heavy drinking can lead to permanent damage to the heart, says Dr. Modi. Other factors that can contribute to an altered heart rate include stress, diabetes, high blood pressure and obesity.
Catrina was given beta blockers – which slow the heart by blocking the action of hormones such as adrenaline – but two days later she rushed back to hospital because she had severe palpitations and they increased her dose.
Dr. Modi says: ‘Treatment of arrhythmias such as AF primarily involves adjusting the lifestyle factors that cause AF, such as stopping drinking, losing weight, eating healthy and exercising.
‘If these measures do not work, medications can be offered to slow the heart. Some patients may need ablation surgery (which destroys the part of the tissue that sends out the faulty electrical signals that cause the arrhythmia) as well as anticoagulant medications to reduce the risk of blood clots and strokes.”
Catrina, who has maintained her more recent healthy lifestyle, such as regularly going to the gym, was able to come off the beta blockers and a recent ECG showed her heart rate has returned to normal. She has since started a podcast, Binge with Catrina, a platform she uses to warn others about the heart risks associated with drinking.
“I never dreamed that my binge eating would cause such problems later in life,” she says. ‘I feel lucky to be here.’