Holiday Heart Syndrome: What It Is and How to Avoid It

With the Christmas festive season quickly approaching, most of us are already picturing the same few weeks: Christmas parties, Boxing Day leftovers, New Year's Eve, then a fortnight of grazing on whatever is left in the tin.

The British festive season is built around food, drink and late nights. For a few weeks, most of us drink more, sleep less and eat far saltier than usual. For some people, that shift is enough to upset the heart's electrical rhythm.

The effect has a name: Holiday Heart Syndrome. Here is what it is, why cardiologists take it seriously, and what you can do to keep yourself and the people around you safe.

Contents

• What Is Holiday Heart Syndrome?
• What Triggers It?
• Why It Matters
• Symptoms to Look Out For
• When to Seek Medical Help
• Reducing Your Risk This Festive Season
• Already Have a Defibrillator? Check It Now
• FAQs
• Sources

What Is Holiday Heart Syndrome?

Holiday Heart Syndrome (HHS)  describes a temporary irregular heartbeat, or arrhythmia, brought on by the lifestyle changes that come with a period of celebration. It was first documented in people who had no known heart disease and who developed rhythm disturbances after a heavy weekend or a run of festive nights out.

The most common presentation is atrial fibrillation, where disorganised electrical signals in the upper chambers of the heart cause a fast, fluttering or uneven pulse.

In many otherwise healthy people the rhythm settles within 24 hours. In others, particularly those with an existing heart condition, it is the first sign of something that needs treating.

What Triggers It?

Alcohol is the main culprit. Drinking heavily in a short space of time affects the way the heart conducts electrical signals and can tip the rhythm out of sync. You do not have to be a regular heavy drinker for it to happen, which is why binge drinking, rather than overall consumption, tends to be the pattern behind it.

Contributing Factors

• Salt: pigs in blankets, gammon, stuffing, crisps and buffet food push sodium intake well above normal, raising blood pressure
• Caffeine: long days and early starts often mean more coffee and more energy drinks than usual
• Poor sleep: late nights, travelling and full houses all cut into recovery time
• Stress: money worries, family tension and the pressure of hosting are genuine physiological stressors
• Cold weather: UK winters narrow blood vessels and raise blood pressure, while flu and other winter infections place additional demand on the heart

Why It Matters

The festive spike in cardiac events is well documented. A large Swedish study published in The BMJ found that the Christmas holiday period carried a 15% higher risk of heart attack compared with a control period, with risk peaking at around 10pm on Christmas Eve, particularly among older people and those already living with illness (The BMJ).

An episode of Holiday Heart Syndrome is usually short lived, but atrial fibrillation carries its own risks. It allows blood to pool in the upper chambers of the heart, raising the chance of a clot forming and travelling to the brain. It can also unmask underlying coronary disease.

The Wider Picture in the UK

• More than 30,000 out of hospital cardiac arrests happen in the UK each year
• Fewer than 1 in 10 people survive one
• Around 80% happen where the person lives
• Bystanders perform CPR in over 70% of cases, but use a public access defibrillator in fewer than 10%

Over Christmas, when most people are at home rather than at work or in a supermarket, that gap between CPR and defibrillation becomes even wider (British Heart Foundation).

Symptoms to Look Out For

• A racing, fluttering or thumping heartbeat
• A pulse that feels uneven or skips
• Breathlessness on mild exertion
• Feeling unusually tired or weak
• Light headedness

When to Seek Medical Help

If you are otherwise healthy and the sensation passes within a few hours, it is still worth mentioning to your GP, especially if it has happened before.

Call 999 Immediately If You Notice

1. Chest pain, tightness or pressure
2. Difficulty breathing
3. Fainting or loss of consciousness
4. Severe dizziness
5. A rapid heartbeat that will not settle

If someone collapses, is unresponsive and is not breathing normally, call 999, start CPR and send someone for the nearest defibrillator. Emergency call handlers can locate the closest registered public access AED through The Circuit, the UK's national defibrillator network. If you are unsure where your nearest device is, our guide on how to find the nearest defibrillator in the UK covers it in full.

Reducing Your Risk This Festive Season

• Pace your drinking, alternate with water and keep some alcohol free days across the period
• Balance the buffet with vegetables, fruit and lighter meals between the big ones
• Keep some form of daily activity going, even if it is only a walk
• Protect your sleep where you can
• Keep taking prescribed medication on schedule, even when the days blur together
• Order enough repeat medication to cover bank holiday pharmacy closures
• If you live with a heart condition, high blood pressure, diabetes or a thyroid disorder, treat the festive period as a time to be more careful rather than less

Already Have a Defibrillator? Check It Now, Not in January

A defibrillator is only as ready as its consumables. Pads and batteries both carry expiry dates, and pads in particular have a habit of running out quietly. If yours expired in the autumn, nobody will notice until the moment it matters most.

Winter also drains battery performance faster, especially in outdoor cabinets, so the festive period is exactly the wrong time to be running on the last few months of shelf life.

Ten Minute Pre Christmas Check

1. Check the expiry date printed on the AED pads currently fitted to your unit, and order replacement pads if they run out within six months
2. Check the expiry date on your current AED battery and the status indicator on the unit, and order a replacement battery if it is close to the end of its life
3. Confirm the self test indicator is showing its ready state
4. Check paediatric pads separately, as they expire on their own schedule
5. Check the cabinet is intact, the heater is working and the access code is known by whoever is on site over the holidays
6. Top up your rescue kit if the razor, shears, gloves or face shield have been used
7. Confirm your defibrillator is registered on The Circuit with current details

It is also worth keeping one spare set of pads on site. Pads cannot be reused after a rescue, so a second set means your defibrillator is ready again immediately rather than out of action while you wait for a delivery. Our guides on when to replace AED pads and batteries and our simple defibrillator maintenance checklistgo into more detail.

Be Prepared: Keep a Defibrillator Within Reach

Knowing CPR and having access to an AED are the two things that most improve survival after a cardiac arrest. Workplaces, village halls, sports clubs, care homes, pubs, hotels and community venues all see higher footfall over the festive season, and a defibrillator on site is the most practical piece of preparation you can make.

Defib Space supplies defibrillators, cabinets and storage, pads and batteries and complete AED packages to workplaces, community groups and organisations across the UK. If you are unsure which model suits your setting, or whether you need an indoor or heated outdoor cabinet, get in touch and we will talk it through with you.

FAQs

• What is Holiday Heart Syndrome?
• How much alcohol triggers an irregular heartbeat?
• Does Holiday Heart Syndrome go away on its own?
• Is Holiday Heart Syndrome the same as a heart attack?
• Should a workplace have a defibrillator over the Christmas period?
• How often should AED pads and batteries be checked?

Sources

• The BMJ, SWEDEHEART observational study 1998 to 2013
• British Heart Foundation, out of hospital cardiac arrest statistics
• Resuscitation Council UK, epidemiology of cardiac arrest guidelines
• NHS, atrial fibrillation