Sustained accelerated idioventricular rhythm in a centrifuge-simulated suborbital spaceflight

Rahul Suresh, Rebecca S. Blue, Charles Mathers, Tarah L. Castleberry, James M. Vanderploeg

    Research output: Contribution to journalArticlepeer-review

    4 Scopus citations

    Abstract

    INTRODUCTION: Hypergravitational exposures during human centrifugation are known to provoke dysrhythmias, including sinus dysrhythmias/tachycardias, premature atrial/ventricular contractions, and even atrial fibrillations or flutter patterns. However, events are generally short-lived and resolve rapidly after cessation of acceleration. This case report describes a prolonged ectopic ventricular rhythm in response to high G exposure. CASE REPORT: A previously healthy 30-yr-old man voluntarily participated in centrifuge trials as a part of a larger study, experiencing a total of 7 centrifuge runs over 48 h. Day 1 consisted of two +Gz runs (peak +3.5 Gz, run 2) and two +Gx runs (peak +6.0 Gx, run 4). Day 2 consisted of three runs approximating suborbital spaceflight profiles (combined +Gx and +Gz). Hemodynamic data collected included blood pressure, heart rate, and continuous three-lead electrocardiogram. Following the final acceleration exposure of the last Day 2 run (peak +4.5 Gx and +4.0 Gz combined, resultant +6.0 G), during a period of idle resting centrifuge activity (resultant vector +1.4 G), the subject demonstrated a marked change in his three-lead electrocardiogram from normal sinus rhythm to a wide-complex ectopic ventricular rhythm at a rate of 91-95 bpm, consistent with an accelerated idioventricular rhythm (AIVR). This rhythm was sustained for 2 m, 24 s before reversion to normal sinus. The subject reported no adverse symptoms during this time. DISCUSSION: While prolonged, the dysrhythmia was asymptomatic and self-limited. AIVR is likely a physiological response to acceleration and can be managed conservatively. Vigilance is needed to ensure that AIVR is correctly distinguished from other, malignant rhythms to avoid inappropriate treatment and negative operational impacts.

    Original languageEnglish (US)
    Pages (from-to)789-793
    Number of pages5
    JournalAerospace Medicine and Human Performance
    Volume88
    Issue number8
    DOIs
    StatePublished - Aug 1 2017

    Keywords

    • Accelerated idioventricular rhythm
    • Acceleration
    • Commercial spaceflight
    • Spaceflight participant

    ASJC Scopus subject areas

    • Medicine (miscellaneous)
    • Public Health, Environmental and Occupational Health

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