Hypoxia and cardiac arrhythmias in breath-hold divers during voluntary immersed breath-holds

The incidence and nature of cardiac arrhythmias during static apnea were studied by monitoring the electrocardiogram (ECG) and oxygen saturation (SaO2) of 16 recreational breath-hold divers. All subjects completed a maximal apnea with a mean (±SD) breath-hold duration of 281 (±73) s without clinical complications. Both heart rate (HR) and SaO2 decreased significantly with breath-hold duration. The decline in SaO2 was inversely related to the decline in HR (r = −0.55, P < 0.05). Cardiac arrhythmias (supraventricular and ventricular premature complexes, right bundle branch block) occurred in 12/16 (77%) subjects and were related to breath-hold duration. Subjects with atrial premature complexes (n = 9) had a reduced BMI (P = 0.016) and a higher decline of the terminal SaO2 (P = 0.01). In conclusion, ectopic arrhythmias were common during maximal static apneas for training purposes. The results indicate that the occurrence of ectopic beats is associated with individual factors such as the tolerable SaO2 decrease.