Variations of intrathoracic amount of blood as a reason of ECG voltage changes

Body Surface Potential Mapping During Heart Ventricular Repolarization in Male Swimmers and Untrained Persons Under Hypoxic and Hypercapnic Hypoxia

Ivonina, Natalya I., Andrey A. Fokin, and Irina M. Roshchevskaya. Body surface potential mapping during heart ventricular repolarization in male swimmers and untrained persons under hypoxic and hypercapnic hypoxia. High Alt Med Biol. 00:000-000, 2021. Background: In swimmers, as a result of prolonged breath-holding during swimming, first hypoxic hypoxia (HH) and then hypercapnic hypoxia (HCH) occurs, which may influence the electrical activity of the heart (EAH). What type of normobaric hypoxia more strongly affects the EAH-normocapnic HH or HCH? Methods: The electrical activity of swimmers' hearts (n = 7) and untrained persons (n = 10) was studied by using electrocardiography (ECG) and body surface potential mapping (BSPM) during the period of ventricular repolarization at baseline, at normocapnic HH, at HCH, and in the recovery period. Results: HH led to more significant changes in the EAH in all participants in comparison with HCH. There was no change in the amplitude of T wave_ECG at hypoxic and HCH, but a change in the amplitude of the minimum was noted in BSPM. The minimum in athletes changed by the end of the exposure (from -0.40 ± 0.12 mV to -0.26 ± 0.11 mV, p = 0.001); in the control, it decreased earlier (after 8 minutes of exposure to HH, the amplitude of the minimum was -0.24 ± 0.08 mV, p = 0.026). With HH, the duration of the QT interval in athletes was shortened due to the shortening of the J-Tpeak (from 250 to 188 ms, p = 0.001) and the Tpeak-Tend (from 98 to 86 ms) intervals. In controls, the decrease in the QT interval was due to the J-Tpeak shortening only (from 280 to 200 ms, p = 0.026). Conclusions: In the study of the effect of hypoxia on the EAH during ventricular repolarization, the use of the BSPM has proven to be more informative than the use of traditional ECG. When using potential mapping, more significant changes in ventricular repolarization at HH than at HCH were revealed, whereas the parameters changed less in swimmers compared with the baseline than in controls during both exposures.