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, then start again,’ says the mother of two.
She drove straight to her GP surgery where initial tests suggested she might indeed be having a heart attack and Catrina, 41, was told to go straight to A&E.
There she was given 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.
Trying to work out why, and having ruled out an underlying heart condition, the consultant asked Catrina whether she drank.
‘I answered truthfully that I used to drink heavily and binge drink, but I’d stopped years ago,’ she says. ‘He said it could still have an impact on my heart’s rhythm and that I could still be recovering even now.’
It may seem an extraordinary outcome for someone who last had an alcoholic drink in 2021, but drinking can cause temporary and longer-term heart rhythm disturbances.
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, typically seen after public holidays.
Rhythm disturbances are where the heart beats too fast, too slowly or irregularly – causing palpitations, dizziness or fatigue. The most common form of irregular heart rhythm is atrial fibrillation (AF), which causes the top chamber in the heart to ‘quiver’ resulting in a rapid and irregular heartbeat. The irregular beats mean blood can pool in the heart, allowing a clot to form.
AF most commonly occurs in older people as 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 don’t have a pre-existing heart condition as a result of heavy drinking.
In the study 193 volunteers with an average age of 29 wore a portable ECG monitor for 48 hours around the time they were going out on a drinking binge and in the hours afterwards. None of them had a heart problem and they usually drank on average 6.8 drinks per week outside their ‘binges’.
Around 5 per cent of the participants developed a heart rhythm disturbance mostly in the 6- to 19-hour ‘recovery period’ after they had stopped drinking, according to the results published in the European Heart Journal in October.
One participant, a 26-year-old man, had a significant rhythm disturbance that lasted an hour, 13 hours after his last drink.
The researchers, from LMU University Hospital, Munich, said their results showed that holiday heart syndrome ‘should be recognised as a relevant health problem’ and called for future studies to analyse ‘why these changes might be happening, and what the consequences could be’.
Heavy drinking creates the perfect storm for a rhythm problem, says Dr Simon Modi, a consultant cardiologist and heart rhythm specialist at Liverpool Heart and Chest Hospital.
Binge drinking regularly over time can lead to high blood pressure and a long-term weakening of the heart muscle, which also increases the likelihood 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’s also due to ‘post-binge dehydration – together with electrolyte imbalance [a loss of potassium and magnesium] due to the diuretic effect of alcohol [meaning you pee more], which can all occur during and immediately after the binge’, he adds. ‘These all increase your risk of heart rhythm problems as they can affect the electrical activity of the heart.’
If you binge drink regularly, over time this can lead to high blood pressure and a long-term weakening of the heart muscle – ‘which also increases the likelihood 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 predispose you to heart rhythm disturbance – such as diabetes, obesity, a family history of AF, prior heart attack or damage to the heart muscle or sleep apnoea [where you stop breathing for short periods as you sleep] – the more likely it is that lower amounts of alcohol will affect your heart,’ Dr Modi explains.
The type of drink may matter, too.
‘One 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 whatsoever of beer and cider increases AF risks.’
Dr Modi says it is not clear why beer and cider are different. ‘Maybe beer and cider drinkers under report how much they drink compared to wine drinkers.’
The good news is that abstaining from alcohol, or dramatically reducing the amount consumed if you’re a heavier drinker, ‘does reduce the likelihood of further episodes of AF or worsening heart problems – so binge drinking in your early 20s might not always lead to long-term arrhythmia if that habit was curbed’, says Dr Modi.
Prior to the episode that left her in hospital, Catrina had had a racing heart from time to time after binges.
‘I could always drink more than anyone else and drank for longer,’ she says – that could be wine, vodka or spirits. ‘I was the picture of propriety Monday to Thursday but then I’d fall off the wagon and drink heavily. I saw it as my end of week treat but it had a dark side.’
That dark side was regularly waking up in the middle of the night with a fast heartbeat.
‘I’d get palpitations that were so strong they’d wake me from my sleep,’ she says. ‘I’d lie there, counting, trying to bring my heart rate down. It began to happen more and more after a binge.’
Things got worse for Catrina during the Covid-19 lockdown.
‘Working from home meant that weekdays meant nothing anymore,’ she says, and she started drinking during the week as well.
In September 2021, Catrina woke in the early hours of the morning with the worst palpitations she’d ever had.
‘I laid there in bed at home praying I’d make it. I thought about my son and daughter, who were just 14 and 15 at the time. What if I died? What if they lost their mother? I knew I had to stop drinking entirely.’
Catrina hasn’t had a drink since. Yet three years after she quit, in January this year, she suffered even worse palpitations while driving to work.
She recalls: ‘By now I was going to the gym, walking, exercising, yet the palpitations were exactly the type I had when I was hungover all those times before.’
Her GP put a pulse monitor on her finger and she watched as her heart jumped from 130 beats per minute down to 40, then up to 90 and down again.
‘The doctor told me to get to hospital, where a consultant would see me urgently,’ Catrina says.
‘I asked if I was having a heart attack and he said tests would confirm this, and 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 grave and said I had an ectopic heartbeat – essentially extra beats where they shouldn’t be.’
Heavy drinking can lead to lasting damage to the heart, says Dr Modi. Other factors that can contribute to an altered heartbeat include stress, diabetes, high blood pressure and being overweight.
Catrina was given beta blockers – these slow down the heart by blocking the action of hormones such as adrenaline – but two days later she rushed back to hospital as she had severe palpitations and they increased her dose.
Dr Modi says: ‘The treatment for rhythm disorders such as AF is to firstly modify the lifestyle factors that trigger AF such as stopping drinking, losing weight, eating healthily and exercising.
‘If these measures don’t work then medication may be offered to slow the heart. Some patients may need an ablation operation [where the part of the tissue sending the faulty electrical signals causing the rhythm disturbance is destroyed] as well as anticoagulant medication to reduce the risk of blood clots and stroke.’
Catrina, who has maintained her more recent healthy lifestyle, for example by regularly going to the gym, was able to come off the beta blockers and a recent ECG showed her heartbeat is back to normal. She has since started a podcast, Binge with Catrina, a platform she uses to warn others of the heart risks associated with drinking.
‘I never dreamed my binging would cause such problems later on in life,’ she says. ‘I feel lucky to be here.’
