Faculty of Sport Sciences, APERE laboratory, EA 3300, University of Picardie Jules Verne, France.
Cardiology Department, CHU Charles Nicolle, Rouen, France.
Eur J Sport Sci. 2021 Mar;21(3):439-449. doi: 10.1080/17461391.2020.1749313. Epub 2020 Apr 26.
Breath-hold divers are known to develop cardiac autonomic changes and brady-arrthymias during prolonged breath-holding (BH). The effects of BH-induced hypoxemia were investigated upon both cardiac autonomic status and arrhythmogenesis by comparing breath-hold divers (BHDs) to non-divers (NDs). Eighteen participants (9 BHDs, 9 NDs) performed a maximal voluntary BH with face immersion. BHDs were asked to perform an additional BH at water surface to increase the degree of hypoxemia. Beat-to-beat changes in heart rate (HR), short-term fractal scaling exponent (DFAα1), the number of arrhythmic events [premature ventricular contractions (PVCs), premature atrial contractions (PACs)] and peripheral oxygen saturation (SpO) were recorded during and immediately following BH. The corrected QT-intervals (QTc) were analyzed pre- and post-acute BH. A regression-based model was used to split BH into a normoxic (NX) and a hypoxemic phase (HX). During the HX phase of BH, BHDs showed a progressive decrease in DFAα1 during BH with face immersion ( < 0.01) and BH with whole-body immersion ( < 0.01) whereas NDs did not ( > 0.05). In addition, BHDs had more arrhythmic events during the HX of BH with whole-body immersion when compared to the corresponding NX phase (5.9 ± 6.7 vs 0.4 ± 1.3; < 0.05; respectively). The number of PVCs was negatively correlated with SpO during BH with whole-body immersion (= -0.72; < 0.05). The hypoxemic stage of voluntary BH is concomitant with significant cardiac autonomic changes toward a synergistic sympathetic and parasympathetic stimulation. Co-activation led ultimately to increased bradycardic response and cardiac electrophysiological disturbances.
屏气潜水员在长时间屏气（BH）期间会出现心脏自主神经变化和心动过缓-心律失常。通过比较屏气潜水员（BHD）和非潜水员（ND），研究了 BH 诱导的低氧血症对心脏自主状态和心律失常发生的影响。18 名参与者（9 名 BHD，9 名 NDs）进行了最大自愿 BH 与面部浸入。要求 BHD 在水面上进行额外的 BH，以增加低氧血症的程度。在 BH 和立即之后，记录心率（HR）、短期分形标度指数（DFAα1）、心律失常事件（室性早搏[PVC]、房性早搏[PAC]）数量和外周血氧饱和度（SpO）的逐拍变化。在急性 BH 前后分析校正的 QT 间隔（QTc）。使用基于回归的模型将 BH 分为正常氧（NX）和低氧（HX）阶段。在 BH 的 HX 期间，BHD 在面部浸入的 BH 期间（ < 0.01）和全身浸入的 BH 期间（ < 0.01）显示 DFAα1逐渐降低，而 NDs 则没有（ > 0.05）。此外，与相应的 NX 期相比，BHD 在全身浸入的 BH 的 HX 期间发生更多的心律失常事件（5.9 ± 6.7 与 0.4 ± 1.3； < 0.05；分别）。在全身浸入的 BH 期间，PVCs 的数量与 SpO 呈负相关（= -0.72； < 0.05）。自愿 BH 的低氧阶段伴随着显著的心脏自主神经变化，表现为交感神经和副交感神经的协同刺激。共同激活最终导致心动过缓反应增加和心脏电生理紊乱。
