Alcohol and sauna bathing: effects on cardiac rhythm, blood pressure, and serum electrolyte and cortisol concentrations.

The effect of heavy drinking and sauna bathing on cardiac rhythm, blood pressure, and serum electrolyte and cortisol concentrations was studied in 10 healthy male volunteers. Sauna bathing induced a comparable, significant increase in heart rate with and without alcohol consumption. During sauna bathing without alcohol, systolic blood pressure remained at the baseline level, whereas sauna and alcohol together decreased systolic blood pressure markedly from 136 +/- 4 to 113 +/- 3 mmHg (P less than 0.01). Neither sauna alone, nor sauna combined with alcohol intake, increased the frequency of premature ventricular complexes. Serum potassium, calcium and cortisol concentrations changed slightly during sauna, but alcohol consumption did not contribute further to this. In conclusion, sauna bathing, even in combination with heavy drinking, does not appear to provoke cardiac arrhythmias in healthy young men. However, the risk of hypotension is increased when sauna bathing is combined with alcohol consumption.     

Arrhythmias and ST segment deviation during prolonged exhaustive exercise (ski marathon) in healthy middle-aged men

To evaluate the occurrence of arrhythmias and silent ischaemiaduring a prolonged exhaustive exercise in cold climate conditions,we monitored 37 healthy middle-aged men (age 40–56 years)who were randomly selected from participants of a ski marathon.Completing the 75–90 km race took 7–12 h. The highestand lowest mean hourly heart rates during skiing were 150 ±9(mean ± SD) and 138 ± 11 beats. Min¹. The maximumheart rate was 161 ±9 beats. min¹, and occurred in mostskiers during the first hour. Ventricular premature complexes(VPCs) were present in 33 of 37 men (89%) with a median frequencyof five beats during skiing (range 0–425). Complex formsoccurred in eight men (22%), and atrial ectopics appeared in33 of 35 participants (94%). The frequency of the arrhythmiasdid not increase over the skiing period At control monitoringduring a representative period the highest mean hourly heartrate was 74 ± 12 beats. min¹ and VPCs were seen in 21men (57%) at a median frequency of one beat during the controlperiod (range 0–338) and complex forms occurred in threemen (8%). Three men had asymptomatic ST segment depression of 0·2–0·3m V lasting 2–10 min during the first hour of skiing.One of them had marginal ST segment depression (0·1 mV) at exercise electrocardiography, but all had normal resultsat exercise thallium scintigraphy and echocardiography. Thus, arrhythmias were significantly (P<0001) increased inmiddle-aged men during exhaustive prolonged exercise as comparedto those observed during a similar period of time of normaldaily life. Transient ST segment depression was found in 8%of skiers at the beginning of the race, although they had notdemonstrated coronary artery disease. This, however may indicatean increased risk during the initial part of the race It is obvious that the risk of cardiac events is increased atthe start of long lasting exhaustive exercise before adaptationto stress, but prolongation of exercise even in cold climatesdoes not increase the risk of arrhythmia or other cardiac complications.However, cold climate conditions and symptoms of respiratoryinfection may increase the risk of cardiac arrhythmias.     

Long-term reduction in sudden deaths after a multifactorial intervention programme in patients with myocardial infarction: 10-year results of a controlled investigation

Three-hundred and seventy-five unselected patients below 65years of age and with acute myocardial infarction participatedin a controlled investigation aimed at studying the effectsof a multifactorial intervention programme on morbidity, mortalityand risk factor control. After ten years' follow-up the significantlylower sudden death and coronary mortality observed three yearsafter myocardial infarction still persisted in the interventiongroup (188 patients) compared with the control group (187 patients).The incidence of sudden death in the intervention group was12.8% compared with 23.0% in the controls (P = 0.01). The incidenceof coronary mortality was 35.1% and 47.1%, respectively (P =0.02). No significant difference was found in the number ofpatients with clinical non-fatal reinfarctions (25.6% and 19.3%,respectively). During the first year, when the mortality differencewas most marked, the use of beta blockers was not significantlydifferent between the groups. The results suggest that with a multifactorial interventionprogramme which starts early after the infarction and lastsfor years a significant long-term reduction in sudden deathsand coronary mortality can be attained.