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Into the Blue: First in Man Data on Diving Physiology in Fontan Patients

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Abstract

Swimming and diving are popular recreational activities. As congenital heart disease, especially patients with univentricular hearts after Fontan palliation are thought to have reduced physiologic capacities for compensation of submersion-associated physiologic demands, current guidelines put restraints on this group of patients. Although these restrictions on doctoral advice place a significant burden on affected patients, it is especially interesting that these guideline recommendations are merely based on physiologic assumptions, i.e., expert consensus. A recent study by Paech et al. presented the first in vivo data on the effects of immersion in Fontan patients, stating no major adverse events in their study group as well as comparable physiologic adaption as reported in the literature for healthy people. Yet, submersion was not reflected in this study, and the current study therefore aimed to conduct a first study for the evaluation of the effects of submersion and apnea diving in Fontan patients. A control group of healthy adults as well as patients recruited from the Heart Center Leipzig, Department of pediatric cardiology underwent a standardized diving protocol including a static as well as dynamic apnea phase. Physiologic data were recorded. This study presents the first structured data on diving physiology in Fontan patients compared to healthy probands. There were no adverse events. The physiologic response to diving seems to be comparable between healthy probands and Fontan patients. Although, healthy probands did reach a much better performance, the basic mechanisms of physiologic adaption seem comparable.

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Funding

The current study was funded by the Kinderherzkammer Leipzig e.V. and the Leipzig Heart Institute. Financial disclosure The authors have no financial relationships relevant to this article to disclose.

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Authors and Affiliations

  1. Department for Pediatric Cardiology, University of Leipzig – Heart Center, Strümpellstr. 39, 04289, Leipzig, Germany

    C. Paech, R. A. Gebauer, M. Weidenbach, A. Michaelis, S. Mensch, J. Weickmann, F. Markel, I. Dähnert, G. Seidel & A. Seidel

  2. Department of Sports Medicine, University of Kiel, Olshausenstr. 74, 24098, Kiel, Germany

    A. Koch

  3. Institute for Applied Scientific Training (IAT), Marschner Str. 29, 04109, Leipzig, Germany

    P. Rüdrich, B. Wolfarth & J. Wüstenfeld

  4. Department of Sports Medicine, Humboldt University and Charité School of Medicine, Berlin, Germany

    B. Wolfarth & J. Wüstenfeld

Authors
  1. C. Paech
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  2. R. A. Gebauer
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  3. M. Weidenbach
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  4. A. Michaelis
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  5. S. Mensch
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  6. J. Weickmann
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  7. F. Markel
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  8. A. Koch
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  9. I. Dähnert
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  10. G. Seidel
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  11. A. Seidel
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  12. P. Rüdrich
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  13. B. Wolfarth
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  14. J. Wüstenfeld
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Contributions

CP, FM, AM, and JW wrote the main manuscript text. AS and GS prepared Figs. 1, 2, 3. JW, MW, and RG prepared Tables 1 and 2. All authors reviewed and approved the manuscript.

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Correspondence to C. Paech.

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The authors declare to have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study received ethical approval by the ethics committee of University of Leipzig and is listed under the reference 549/19-ek.

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Paech, C., Gebauer, R.A., Weidenbach, M. et al. Into the Blue: First in Man Data on Diving Physiology in Fontan Patients. Pediatr Cardiol 44, 179–186 (2023). https://doi.org/10.1007/s00246-022-02966-1

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  • DOI: https://doi.org/10.1007/s00246-022-02966-1

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