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Short‐term high altitude exposure at 3454 m is well tolerated in patients with stable heart failure
Author(s) -
Schmid JeanPaul,
Nobel Daniel,
Brugger Nicolas,
Novak Jan,
Palau Patricia,
Trepp Anja,
Wilhelm Matthias,
Saner Hugo
Publication year - 2015
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1002/ejhf.227
Subject(s) - medicine , heart failure , cardiology , heart rate , altitude (triangle) , effects of high altitude on humans , ventricular tachycardia , tachycardia , hemodynamics , anesthesia , blood pressure , geometry , mathematics , anatomy
Aims High altitude exposure for the purpose of tourism is very popular in mountainous regions and is considered to be safe for patients with stable CAD and preserved LV function. The purpose of this study was to evaluate the haemodynamic response to exercise and electrical stability by Holter monitoring in patients with chronic heart failure ( HF ) and an EF <40%. Methods and results We studied 29 HF patients with a peak VO 2 >50% of the predicted (25 men, age 60.0 ± 8.9 years, EF 28.8 ± 5.4%) at 540 and 3454 m after an ascent using public transport. Assessments of exercise capacity (cardiopulmonary exercise test), haemodynamic response (inert gas rebreathing system), and susceptibility to arrhythmias (Holter ECG recording) were performed. None of the patients (19 with ischaemic heart disease, 11 with an implantable cardioverter defibrillator) had to return prematurely to the lowland site. Two patients presented symptoms of mild mountain sickness, and one patient developed a self‐limited ventricular tachycardia during maximal exercise at high altitude. Mean peak VO 2 at the lowland site was 18.5 ± 3.6 mL /min/kg and decreased by 22.2% ( P < 0.001) at high altitude. Mean resting heart rate increased from 74.3 ± 12.3 to 83.3 ± 13.4 b.p.m., P < 0.001. No statistically significant difference in premature ventricular contractions (92 ± 150/h at 540 m vs. 111 ± 196/h at 3454 m, P = 0.284) was noted. Conclusion Patients with stable chronic HF and a peak VO 2 >50% of the predicted tolerate a short exposure to an altitude of 3454 m well, even during exercise. However, it cannot be excluded that the susceptibility to ventricular tachyarrhythmias during exercise is increased in some subjects.