Human tecg changes during prolonged hyperbaric exposures breathing N2-O2 mixtures

Abstract

In an effort to determine whether hyperbaric exposures while breathing N2-O2 mixtures have an effect on cardiac depolarization and repolarization, electrocardiograms of 10 divers participating in four N2-O2 saturation dives were analyzed. In all cases, a decline in heart rate was observed upon compression to saturation depth (20–30%); a slow adaptation and return of heart rate toward normal was observed in those dives where the depth and environmental parameters remained constant. twhenever excursion dives were performed, the heart rate responded by decreasing on deeper excursions and increasing on upward excursions. Hyperbaric bradycardia disappeared after 8 days at pressure during the saturation dives at 50 and 60 feet seawater gauge (fswg), but was still present at this time at 200 fswg. The magnitude of the hyperbaric bradycardia produced by excursion dives following saturation at depth was influenced by the state of adaptation of heart rate. Decompression was uniformly accompanied by a rapid increase in heart rate resulting in a significant elevation in the postdive period. Alterations in myocardial repolarization as evidenced by Q-T interval, ST, and T wave changes were observed. Development of slight right ventricular conduction delay compatible with right ventricular strain was noted in four of the divers during the two deepest dives to 100 and 198 fswg. During the latter dive, progressive decrease in P wave amplitudes and eventual loss of P waves resulting in an apparent nodal rhythm was observed in one diver. Multiple premature ventricular contractions occurred in another diver. These observations, along with the reports by other authors, suggest that the different variables associated with the hyperbaric environment--gas density, pressure, inert gas--have a definite effect on the pacemaker activity of the heart and myocardial depolarization and repolarization.