Arrhythmia secondary to cold water submersion during helicopter underwater escape training

Kaur, Paven P, Drummond, Sarah E and Furyk, Jeremy 2016, Arrhythmia secondary to cold water submersion during helicopter underwater escape training, Prehospital and disaster medicine, vol. 31, no. 1, pp. 108-110, doi: 10.1017/S1049023X15005464.

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Title Arrhythmia secondary to cold water submersion during helicopter underwater escape training
Author(s) Kaur, Paven P
Drummond, Sarah E
Furyk, JeremyORCID iD for Furyk, Jeremy
Journal name Prehospital and disaster medicine
Volume number 31
Issue number 1
Start page 108
End page 110
Total pages 3
Publisher Cambridge University Press
Place of publication Cambridge, Eng.
Publication date 2016-02
ISSN 1049-023X
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Emergency Medicine
atrial fibrillation
helicopter underwater escape training
water submersion
Summary A 32-year-old, fit and healthy, Caucasian male presented with a less than 24-hour history of palpitations with the onset following participation in helicopter underwater escape training (HUET). He reported no chest pain, shortness of breath, syncope, or pre-syncope symptoms. On examination, an irregularly irregular pulse was noted at a rate of 120 beats per minute with a blood pressure of 132/84. There was no evidence of congestive cardiac failure. The electrocardiogram (ECG) demonstrated atrial fibrillation at 97 beats per minute with a normal axis, normal QRS complexes, and a QTc of 399 ms. Bloods were all within normal limits and a chest x-ray showed no abnormality. The patient was loaded with amiodarone and reverted to sinus rhythm with a normal post-reversion ECG. Five years on, following further HUET, the patient presented with an identical presentation. His ECG showed fast atrial fibrillation at a rate of 115 beats per minute. On this occasion, he was sedated and Direct Current cardioverted with reversal to sinus rhythm after one shock. It was felt that the precipitating factor for this patient’s atrial fibrillation, in both cases, was HUET. The case discussed describes a previously fit and well subject who developed a sustained arrhythmia secondary to cold water submersion. Evidence suggests water submersion can provoke cardiac arrhythmias via the suggested theory of “autonomic conflict.” It has been proposed that a number of unexplained deaths related to water submersion may be secondary to arrhythmogenic syncope.
Language eng
DOI 10.1017/S1049023X15005464
Indigenous content off
Field of Research 11 Medical and Health Sciences
HERDC Research category C1 Refereed article in a scholarly journal
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Document type: Journal Article
Collections: Faculty of Health
School of Medicine
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