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Kuschyk J, Haghi D, Borggrefe M, Wolpert C, Brade J. Cardiovascular Response to a Modern Roller Coaster Ride. JAMA. 2007;298(7):739–741. doi:10.1001/jama.298.7.739-c
Letters Section Editor: Robert M. Golub, MD, Senior Editor.
To the Editor: Cardiovascular responses to older roller coaster rides have been studied,1 but technological advances have created rides that generate greater physical forces. We investigated cardiovascular responses to a modern roller coaster ride.
Healthy volunteers aged 18 years or older were recruited from consecutive amusement park visitors intending to ride a roller coaster (Expedition GeForce, Holiday Park, Hassloch, Germany). Exclusion criteria were pregnant state; symptoms or history of cardiovascular disease or cardiac risk factors; history of syncope or presyncope, migraine, epilepsy, or other neurological disorder; use of medication other than oral contraceptives; measured blood pressure greater than 160 mm Hg systolic or 100 mm Hg diastolic, or abnormal cardiac or pulmonary examination findings immediately before the ride. Of 56 consecutive participants, 55 (37 men) were included in the study (Table 1); 1 was excluded due to history of cardiac disorder.
All participants underwent 12-lead Holter electrocardiogram recording from a minimum of 5 minutes before the roller coaster ride until a minimum of 5 minutes after the ride. The ride lasted 120 seconds, starting with a slow ascent for 30 seconds to a height of 62 m, followed by a 4-second free-fall period (4.5g), and a 4-second negative-gravity-force air time element (−1.5g). In the remaining 82 seconds, there were 6 more air times and several sharp curves. The maximum speed was 120 km per hour.2 Participants pressed the recorder marker button at the start of the ride so that the electrocardiograph recording could be mapped to particular sections of the ride.
Differences in heart rate by sex were tested using a 2-sample t test. Subgroup changes of the heart rate (baseline to maximum) were compared by paired t tests. The absence of relevant parameter estimates precluded a power analysis. A 2-sided P value ≤ .05 was considered statistically significant. Descriptive statistics and other analyses were performed using SAS version 8.2 (SAS Institute Inc, Cary, North Carolina).
Ethics Committee approval was given for this study and all participants provided written informed consent; they did not receive compensation
The mean (SD) heart rate increased from 89/min (20/min) before the ride to a maximum of 155/min (22/min) during the ride, followed by 109/min (27/min) at the end of the ride (Table 2). The largest increase in heart rate occurred during the first 30 seconds of the ascent. Heart rates were significantly higher in women than men at all points after the start of the ride, including the maximum heart rate (165/min vs 148/min; P = .01). There was a mean increase in blood pressure from baseline to end of the ride of 19 mm Hg systolic and 5 mm Hg diastolic.
In 24 (44%) of the 55 participants, asymptomatic sinus arrhythmias were recorded up to 5 minutes after the ride. One individual experienced a 4-second self-terminating episode of atrial fibrillation immediately after the end of the ride with a heart rate of 140/min, accompanied by palpitations. Another individual experienced an asymptomatic episode of nonsustained (3 complex) ventricular tachycardia 20 seconds after the start of the initial ascent.
In a group of presumably healthy individuals, this modern roller coaster ride led to a pronounced rise in heart rate. The largest rate increase occurred during the ascent, where speed was low and there were no significant acceleration forces, suggesting a contributing role of emotional stress. Limitations include the inability to measure changes in blood pressure during the ride, or to assess any effect of repeated exposures to the same ride.
A 1989 study1 reported an increase of heart rate in 13 persons riding a roller coaster, with a mean maximum rate of 154/min. Supraventricular or ventricular tachyarrhythmias were not detected. However, the roller coaster in that study had a maximum speed of only 64 km per hour and a maximum acceleration of 3g. Contemporary roller coasters may achieve speeds greater than 200 km per hour and acceleration forces of 6g.3 In a systematic evaluation of 40 roller coaster fatalities over a 10-year period, at least 7 deaths were attributed to cardiac causes.4 Although the arrhythmias observed in our study of healthy individuals were benign, the magnitude of increase in heart rate raises the possibility of risk for individuals with underlying cardiac disease.
Financial Disclosures: None reported.
Author Contributions: Dr Kuschyk had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Study concept and design: Kuschyk, Borggrefe, Wolpert.
Acquisition of data: Kuschyk, Brade, Borggrefe, Haghi.
Analysis and interpretation of data: Kuschyk, Brade, Borggrefe, Wolpert, Haghi.
Drafting of the manuscript: Kuschyk, Borggrefe, Wolpert.
Critical revision of the manuscript for important intellectual content: Brade, Borggrefe, Wolpert, Haghi.
Statistical Analysis: Kuschyk, Brade, Wolpert.
Study supervision: Kuschyk, Borggrefe, Wolpert, Haghi.
Funding/Support: The Holter electrocardiogram recorder was provided from Mortara Instuments Inc, Milwaukee, Wisconsin.
Role of the Sponsor: Mortara Instuments Inc did not participate in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript.
Additional Contributions: We thank Mr Wolfgang Schneider, director, Holiday Park, Hassloch, Germany, and his staff for the opportunity to perform this study. We thank Axel Kobudzinski for the preparation of the recorded Holter electrocardiographs. Neither Mr. Kobudzinski nor Mr. Schneider received compensation for their role in the study.
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