{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,3]],"date-time":"2022-04-03T22:42:35Z","timestamp":1649025755394},"reference-count":10,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2016,1,12]],"date-time":"2016-01-12T00:00:00Z","timestamp":1452556800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Prehosp. Disaster med."],"published-print":{"date-parts":[[2016,2]]},"abstract":"Abstract<\/jats:title>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\u2019s 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 \u201cautonomic conflict.\u201d It has been proposed that a number of unexplained deaths related to water submersion may be secondary to arrhythmogenic syncope.<\/jats:p>Kaur<\/jats:surname>PP<\/jats:given-names><\/jats:name>, Drummond<\/jats:surname>SE<\/jats:given-names><\/jats:name>, Furyk<\/jats:surname>J<\/jats:given-names><\/jats:name>. Arrhythmia secondary to cold water submersion during helicopter underwater escape training<\/jats:article-title>. Prehosp Disaster Med<\/jats:source>. 2016<\/jats:year>;31<\/jats:volume>(1<\/jats:issue>):108<\/jats:fpage>\u2013110<\/jats:lpage>.<\/jats:mixed-citation><\/jats:p>","DOI":"10.1017\/s1049023x15005464","type":"journal-article","created":{"date-parts":[[2016,1,12]],"date-time":"2016-01-12T10:27:47Z","timestamp":1452594467000},"page":"108-110","source":"Crossref","is-referenced-by-count":1,"title":["Arrhythmia Secondary to Cold Water Submersion during Helicopter Underwater Escape Training"],"prefix":"10.1017","volume":"31","author":[{"given":"Paven P.","family":"Kaur","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah E.","family":"Drummond","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy","family":"Furyk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2016,1,12]]},"reference":[{"key":"S1049023X15005464_ref5","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.01201.2005"},{"key":"S1049023X15005464_ref9","doi-asserted-by":"publisher","DOI":"10.3357\/ASEM.2700.2010"},{"key":"S1049023X15005464_ref8","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2012.229864"},{"key":"S1049023X15005464_ref10","doi-asserted-by":"publisher","DOI":"10.1007\/BF02691277"},{"key":"S1049023X15005464_refa1","doi-asserted-by":"publisher","DOI":"10.1017\/S1049023X15005464"},{"key":"S1049023X15005464_ref6","unstructured":"Careflight Training Academy. Helicopter Underwater Escape Training (HUET). https:\/\/www.careflight.org.au\/page\/what-we-do\/careflight-training-services\/HUET_Training\/About_HUET\/. Accessed February 22, 2015."},{"key":"S1049023X15005464_ref3","doi-asserted-by":"publisher","DOI":"10.1042\/cs0770581"},{"key":"S1049023X15005464_ref7","unstructured":"ERGT Australia. Basic Offshore Safety Induction and Emergency Training (BOSIET). http:\/\/www.ergt.com.au\/courses\/core-safety\/basic-offshore-safety-induction-and-emergency-training-bosiet.aspx. Accessed February 22, 2015."},{"key":"S1049023X15005464_ref4","first-page":"305","article-title":"Supraventricular arrhythmias following breath-hold submersions in cold water","volume":"21","author":"Tipton","year":"1994","journal-title":"Undersea Hyperb Med"},{"key":"S1049023X15005464_ref2","unstructured":"World Health Organization. World Health Fact Sheet Drowning 2014. http:\/\/www.who.int\/mediacentre\/factsheets\/fs347\/en\/. Published 2014. Accessed February 22, 2015."}],"container-title":["Prehospital and Disaster Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1049023X15005464","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,19]],"date-time":"2019-04-19T22:28:56Z","timestamp":1555712936000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1049023X15005464\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,1,12]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2016,2]]}},"alternative-id":["S1049023X15005464"],"URL":"https:\/\/doi.org\/10.1017\/s1049023x15005464","relation":{},"ISSN":["1049-023X","1945-1938"],"issn-type":[{"value":"1049-023X","type":"print"},{"value":"1945-1938","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,1,12]]}}}