What does this research mean for the field?

Moderately cold water immersion and swimming are haemodynamically well-tolerated in patients with compensated chronic heart failure, but significantly increase the frequency of premature ventricular contractions. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To investigate the haemodynamic and arrhythmic effects of moderately cold water on patients with chronic heart failure and stable coronary artery disease.

August 20, 2009European Journal of Heart Failure

Haemodynamic and Arrhythmic Effects of Moderately Cold (22°C) Water Immersion and Swimming in Patients with Stable Coronary Artery Disease and Heart Failure

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Why the study?

Does moderately cold water immersion and swimming affect haemodynamics and arrhythmias in patients with stable CAD and CHF?

Key Points

To investigate the haemodynamic and arrhythmic effects of moderately cold water on patients with chronic heart failure and stable coronary artery disease.
Examined 22 male patients, including 12 with chronic heart failure and 10 with stable coronary artery disease.
Measured haemodynamic effects using an inert gas rebreathing method during water immersion and swimming at two temperatures.
Conducted 24-hour ECG recordings to monitor arrhythmia occurrence.
Rate pressure product significantly increased in moderately cold water immersion compared to warm water (P = 0.043 in CHF, P = 0.028 in CAD patients).
PVCs increased significantly in CHF patients in moderately cold water (from 15 +/- 41 to 76 +/- 163 beats per 30 min, P = 0.013), while no significant change was seen in CAD patients.
No cases of ventricular tachycardia were observed during the study.

Structured PICO

Does moderately cold water immersion and swimming affect haemodynamics and arrhythmias in patients with stable CAD and CHF?

Population

22 male patients, including 12 with chronic heart failure (CHF) (mean age 59 years, ejection fraction 32%, NYHA class II) and 10 with stable coronary artery disease (CAD) without CHF (mean age 65 years, ejection fraction 52%).

Intervention

Water immersion and swimming in moderately cold (22°C) water.

Comparator

Water immersion and swimming in warm (32°C) water, and baseline 24-hour ECG recording.

Outcome

Haemodynamic effects (rate pressure product, cardiac index, oxygen consumption) and occurrence of arrhythmias (premature ventricular contractions, ventricular tachycardia).surrogate

While moderately cold water immersion is haemodynamically well-tolerated in compensated CHF, it significantly increases premature ventricular contractions, raising concerns for potential high-grade ventricular arrhythmias.

Discussion

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Implication

Cold water immersion may provoke ventricular ectopy in compensated CHF; this observational finding leaves open swimming safety and requires prospective confirmation.

Cite This Study

Schmid et al. (2009) studied this question.

synapsesocial.com/papers/6a1d33e0cc9f7df1b7050ea8 https://doi.org/10.1093/eurjhf/hfp114

Topics

HFrEF treatment Heart failure Coronary artery disease

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Implication

Cold water immersion may provoke ventricular ectopy in compensated CHF; this observational finding leaves open swimming safety and requires prospective confirmation.

Haemodynamic and Arrhythmic Effects of Moderately Cold (22°C) Water Immersion and Swimming in Patients with Stable Coronary Artery Disease and Heart Failure

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Haemodynamic and Arrhythmic Effects of Moderately Cold (22°C) Water Immersion and Swimming in Patients with Stable Coronary Artery Disease and Heart Failure

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

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