Contribution of the Autonomic Nervous System to Recovery in Firefighters

J Athl Train. 2020 Sep 1;55(9):1001-1008. doi: 10.4085/1062-6050-0426.19.

Abstract

Context: Sudden cardiac deaths (SCDs) have accounted for nearly half of the line-of-duty deaths among US firefighters over the past 10 years. In 2018, 33% of all SCDs occurred after the end of a fire service call. Researchers have suggested that an imbalance in autonomic nervous system (ANS) regulation of heart rate postcall may interfere with recovery in firefighters.

Objective: To use heart-rate recovery (HRR) and heart-rate variability (HRV), 2 noninvasive markers of ANS function, to examine the ANS recovery profiles of firefighters.

Design: Cross-sectional study.

Setting: Firehouse and research laboratory.

Patients or other participants: Thirty-seven male career active-duty firefighters (age = 39 ± 9 years, height = 178.8 ± 5.4 cm, mass = 87.9 ± 11.2 kg).

Main outcome measure(s): Percentage of maximal HR (%MHR) and HRV (natural log of the square root of the mean sum of the squared differences [lnRMSSD]) were collected after both submaximal and maximal exercise protocols during a 10-minute seated recovery. The HRR profiles were examined by calculating the asymptote, amplitude, and decay parameters of the monoexponential HRR curve for each participant.

Results: Differences in HRR parameters after 10 minutes of seated recovery were identified after submaximal versus maximal exercise (P < .001). In addition, although ANS was more suppressed after maximal exercise, HRV indicated incomplete recovery, and regardless of the test, recovery %MHR and lnRMSSD values did not return to pretest %MHR and lnRMSSD values.

Conclusions: Our results suggest that the ANS contributions to recovery in active-duty firefighters are exercise-intensity specific, and this is likely an important factor when establishing best-practice recovery guidelines.

Keywords: blood lactate; heart-rate recovery; heart-rate variability; sympathetic nervous system; vagal reactivation.

MeSH terms

  • Adult
  • Autonomic Nervous System / physiopathology*
  • Cross-Sectional Studies
  • Death, Sudden, Cardiac* / epidemiology
  • Death, Sudden, Cardiac* / etiology
  • Death, Sudden, Cardiac* / prevention & control
  • Exercise / physiology*
  • Exercise Test / methods
  • Female
  • Firefighters*
  • Heart Rate / physiology*
  • Humans
  • Male
  • Rest / physiology*