Ranic Ivan, Jiravsky Otakar, Cesnakova Konecna Alica, Jiravska Godula Bogna, Pesova Petra, Chovancik Jan, Neuwirth Radek, Sknouril Libor, Pudil Radek, Plasek Jiri
Department of Cardiology, Agel Hospital Trinec-Podlesi, Konska 453, 739 61 Trinec, Czech Republic.
Research Center for Internal and Cardiovascular Diseases, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic.
J Clin Med. 2024 Sep 6;13(17):5298. doi: 10.3390/jcm13175298.
This review examines the relationship between the physiological demands of diving and premature ventricular complexes (PVCs) in divers. In the general population, some individuals have a greater tendency to experience PVCs, often without awareness or a clear understanding of the triggering factors. With the increasing availability and popularity of both scuba and apnoea diving, more people, including those with a predisposition to PVCs, are engaging in these activities. The underwater environment, with its unique stressors, may increase the risk of arrhythmogenic events, particularly PVCs. Here, we review the prevalence, pathophysiology, and aggravating factors of PVCs in divers, emphasising the need for a comprehensive cardiovascular assessment. Evidence suggests a higher prevalence of PVCs in divers compared with the general population, influenced by factors such as age, dive depth, gas bubbles, cold water immersion, pre-existing cardiovascular diseases, and lifestyle factors. The change in environment during diving could potentially trigger an increased frequency of PVCs, especially in individuals with a pre-existing tendency. We discuss diagnostic strategies, management approaches, and preventive measures for divers with PVCs, noting that although guidelines for athletes can be adapted, individual assessment is crucial. Significant knowledge gaps are identified, highlighting the need for future research to develop evidence-based guidelines and understand the long-term significance of PVCs in divers. This work aims to evaluate potential contributing factors to PVCs in divers and identify individuals who may be at higher risk of experiencing major adverse cardiovascular events (MACEs). This work aims to improve diver safety by promoting collaboration between cardiologists and diving medicine specialists and by identifying key areas for future investigation in this field. This work aims to improve the safety and well-being of divers by understanding the cardiovascular challenges they face, including pressure changes, cold water immersion, and hypoxia. We seek to elucidate the relationship between these challenges and the occurrence of PVCs. By synthesising current evidence, identifying knowledge gaps, and proposing preliminary recommendations, we aim to encourage collaboration between cardiologists and diving medicine specialists to optimise the screening, management, and risk stratification of PVCs in the diving population.
本综述探讨了潜水的生理需求与潜水员室性早搏（PVCs）之间的关系。在一般人群中，一些人更容易出现室性早搏，通常没有意识到或清楚了解触发因素。随着水肺潜水和憋气潜水的日益普及，越来越多的人，包括那些易患室性早搏的人，开始参与这些活动。水下环境及其独特的应激源可能会增加心律失常事件的风险，尤其是室性早搏。在此，我们综述了潜水员室性早搏的患病率、病理生理学和加重因素，强调了进行全面心血管评估的必要性。有证据表明，与一般人群相比，潜水员室性早搏的患病率更高，这受到年龄、潜水深度、气泡、冷水浸泡、既往心血管疾病和生活方式因素等影响。潜水过程中的环境变化可能会潜在地引发室性早搏频率增加，尤其是在已有发病倾向的个体中。我们讨论了室性早搏潜水员的诊断策略、管理方法和预防措施，指出虽然可以借鉴运动员的指导方针，但个体评估至关重要。发现了重大的知识空白，突出了未来研究制定循证指南并了解室性早搏在潜水员中的长期意义的必要性。这项工作旨在评估潜水员室性早搏的潜在促成因素，并识别可能面临重大不良心血管事件（MACEs）更高风险的个体。这项工作旨在通过促进心脏病专家和潜水医学专家之间的合作，并确定该领域未来研究的关键领域来提高潜水员的安全性。这项工作旨在通过了解潜水员面临的心血管挑战，包括压力变化、冷水浸泡和缺氧，来改善潜水员的安全和健康状况。我们试图阐明这些挑战与室性早搏发生之间的关系。通过综合现有证据、识别知识空白并提出初步建议，我们旨在鼓励心脏病专家和潜水医学专家之间的合作，以优化潜水人群中室性早搏的筛查、管理和风险分层。
