Cardiac arrest following holiday heart syndrome

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.