Habibe KAFES, Yücel YÜZBAŞIOĞLU, Gültekin Günhan DEMİR

Serbest dalış öncesi ve sonrası elektrokardiyografik değişikliklerin incelenmesi

Amaç: Serbest dalış statik apne performansı ile maksimum nefes tutma sonrası aritmi gelişimini öngörmede elektrokardiyografik (EKG) parametreleri ve hemodinamik göstergeleri değerlendirmek. Gereç ve Yöntemler: Çalışmaya 2015 yılında düzenlenen serbest dalış yarışmasına katılan 24 gönüllü sporcu dahil edilmiştir (19 erkek (%79,2) and 5 kadın (%20,8)). Performans öncesi ve sonrası ( 5. dakikada) periferik O2 satürasyonu ( pO2), kalp hızı (KH), EKG parametreleri ( PR aralığı, QRS süresi, T dalga amplitüdü, düzeltilmiş QT süresi, dal bloğu varlığı ve yeni dal bloğu gelişimi, atriyal erken atım, ventriküler erken atım varlığı) analiz edildi. Bulgular: Sporcuların statik apne öncesi sistolik kan basınçları (SKB) 124,7±10,8 mmHg, diyastolik kan basınçları (DKB) 76,5±6,7 mmHg, kalp hızı 80,2 ±13,4 atım/dk, pO2 %97,1±0,9 ve performans sonrası SKB 128,8±13,6 mmHg, DKB 78,0 ±5,9 mmHg, KH 85,8±16,5 atım/dk, pO2 %96,7±2,3 arasında istatistiksel olarak anlamlı fark saptanmadı ( sırasıyla p=0,175; p=0,334; p=0,104; p=0,336). Sonuç: Statik apne performansı sonrası değerlendirilen EKG parametrelerinde, kalp hızında, satürasyon ve tansiyon değerlerinde herhangi bir anlamlı değişiklik izlenmedi. Bu bulgular statik apne esnasında gelişebilecek aritmi riskinin apne sonlandıktan sonra devam etmediğini desteklemede kullanılabilir.

Anahtar Kelimeler:

aritmi, serbest dalış, elektrokardiyografi

Investigation of changes in electrocardiography before and after free diving

Aim: To evaluate the electrocardiographic (ECG) parameters and hemodynamic parameters in predicting the development of arrhythmias after free diving static apnea performance and maximum breath hold. Material and Methods: Twenty-four volunteer athletes participating in the free diving competition in 2015 (19 males (79.2%) and 5 females (20.8%)) were included in the study. Peripheral O2 saturation (SpO2), heart rate (HR), ECG parameters (PR interval, QRS time, T wave amplitude, corrected QT time, presence of bandle branch block and new bandle branch block development, atrial premature beats, ventricular premature beats) were analyzed. Results: There was no statistically significant difference between before static apnea measurements (systolic blood pressure (SBP) 124.7 ± 10.8 mmHg, diastolic blood pressure (DBP) 76.5 ± 6.7 mmHg, heart rate (HR) 80.2 ± 13.4 beats / min, SpO2 97.1 ± 0.9%) and after performance (SBP 128.8 ± 13.6 mmHg DBP 78.0 ± 5.9 mmHg, HR 85.8, ± 16.5 beats / min and SpO2 96.7 ± 2.3%)(p = 0.175; p = 0.334; p = 0.104; p = 0.336, respectively). Conclusion: No significant changes were observed in ECG parameters, heart rate, saturation and blood pressure values evaluated after static apnea performance. These findings can be used to support that the risk of arrhythmia during static apnea does not persist after apnea has ended.

Keywords:

arrhythmia, free diving, electrocardiography,

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1.Lindholm P. Loss of motor control and/or loss of consciousness during breath-hold competitions. International Journal Of Sports Medicine 2007; 28: 295-99
2.Irving L. Bradycardia in human divers. J Appl Physiol 1963; 18: 489-91.
3.Hong SK, Rahn H. The diving women of Korea and Japan. Scientific American 1967; 216: 34-43.
4.Olsen CR, Fanestil DD, Scholander PF. Some effects of breath holding and apneic underwater diving on cardiac rhythm in man. J Appl Physiol 1962; 17: 461-66.
5.Stewart IB, Bulmer AC, Sharman JE, Ridgway L. Arterial oxygen desaturation kinetics during apnea. Medicine And Science In Sports And Exercise 2005; 37: 1871-76.
6.Schagatay E, Holm B. Effects of water and ambient air temperatures on human diving bradycardia. European Journal Of Applied Physiology And Occupational Physiology 1996; 73: 1-6.
7.Campbell LB, Gooden BA, Horowitz JD. Cardiovascular responses to partial and total immersion in man. The Journal Of Physiology 1969; 202: 239-50.
8.Sterba JA, Lundgren CE. Breath-hold duration in man and the diving response induced by face immersion. Undersea Biomedical Research 1988; 15: 361-75.
9.Gooden BA. Mechanism of the human diving response. Integrative physiological and behavioral science. The Official Journal Of The Pavlovian Society 1994; 29: 6-16.
10.Weston CF, O'Hare JP, Evans JM, Corrall RJ. Haemodynamic changes in man during immersion in water at different temperatures. Clinical Science 1987; 73: 613-16.
11.Yamaguchi H, Tanaka H, Obara S et al. Changes in cardiac rhythm in man during underwater submersion and swimming studied by ECG telemetry. European Journal Of Applied Physiology And Occupational Physiology 1993; 66: 43-48.
12.Ferrigno M, Ferretti G, Ellis A et al. Cardiovascular changes during deep breath-hold dives in a pressure chamber. Journal of applied physiology. 1997; 83: 1282-90.
13.Ferrigno M, Grassi B, Ferretti G, Costa M, Marconi C, Cerretelli P, et al. Electrocardiogram during deep breath-hold dives by elite divers. Undersea Biomedical Research 1991; 18: 81-91.
14.Muth CM, Ehrmann U, Radermacher P. Physiological and clinical aspects of apnea diving. Clinics In Chest Medicine 2005; 26: 381-94. 15.Park KS, Choi JK, Park YS. Cardiovascular regulation during water immersion. Applied human science . Journal Of Physiological Anthropology. 1999; 18: 233-41.
16.Fitz-Clarke JR. Breath-Hold Diving. Comprehensive Physiology 2018; 8: 585-630.