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Aim <p>This pilot study aimed to systematically evaluate exercise-induced electrocardiographic (ECG) responses in professional firefighters and to explore the association between premature ventricular complexes (PVCs) and myocardial ischemia in this high-risk occupational group.</p> Method <p>This pilot cross-sectional study enrolled 21 male firefighters (mean age 43.4 ± 7.18&#xa0;years) from a single municipal fire department. Participants underwent comprehensive cardiovascular assessment including anthropometric measurements, biochemical analyses (lipid profile, testosterone), submaximal exercise testing (Bruce protocol), and 24-h Holter ECG monitoring. Statistical analyses included Mann–Whitney U tests and effect size calculations.</p> Results <p>No exercise-induced ST-segment changes indicative of myocardial ischemia were observed. However, PVCs were detected in 33% of participants (7/21), with exercise testing revealing 18 simple and 2 multiform PVCs, while Holter monitoring recorded 25 simple and 1 multiform PVC. PVC-positive firefighters were significantly older (median 49 vs. 40&#xa0;years, p = 0.019, r = 0.514). Mean exercise capacity was 12.45 METs, with 81% achieving moderate fitness levels. Post-exercise heart rate recovery (HRR1: 24 ± 11.5&#xa0;bpm; HRR2: 35.4 ± 11.5&#xa0;bpm) showed normal patterns.</p> Conclusion <p>The findings of this pilot study indicate the need for larger-scale investigations, supported by advanced diagnostic modalities, to clarify the clinical relevance of exercise-induced premature ventricular complexes (PVCs) in firefighters. Although no ischemic changes were observed, the presence of subclinical coronary artery disease cannot be definitively excluded. These results provide a meaningful preliminary foundation for developing targeted screening approaches to improve early cardiovascular risk detection in high-physical-demand occupational groups.</p> Graphical abstract <p></p>

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Exercise-induced ventricular arrhythmias and subclinical ischemia risk in firefighters: exploratory results from a pilot study

  • 期刊论文

  • 发表日期：

    2025年10月2日

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  • Nuray Demiralp,
  • Serdar Akyel,
  • Hürmüz Koç,
  • Ahmet Öztürk

摘要

Aim

This pilot study aimed to systematically evaluate exercise-induced electrocardiographic (ECG) responses in professional firefighters and to explore the association between premature ventricular complexes (PVCs) and myocardial ischemia in this high-risk occupational group.

Method

This pilot cross-sectional study enrolled 21 male firefighters (mean age 43.4 ± 7.18 years) from a single municipal fire department. Participants underwent comprehensive cardiovascular assessment including anthropometric measurements, biochemical analyses (lipid profile, testosterone), submaximal exercise testing (Bruce protocol), and 24-h Holter ECG monitoring. Statistical analyses included Mann–Whitney U tests and effect size calculations.

Results

No exercise-induced ST-segment changes indicative of myocardial ischemia were observed. However, PVCs were detected in 33% of participants (7/21), with exercise testing revealing 18 simple and 2 multiform PVCs, while Holter monitoring recorded 25 simple and 1 multiform PVC. PVC-positive firefighters were significantly older (median 49 vs. 40 years, p = 0.019, r = 0.514). Mean exercise capacity was 12.45 METs, with 81% achieving moderate fitness levels. Post-exercise heart rate recovery (HRR1: 24 ± 11.5 bpm; HRR2: 35.4 ± 11.5 bpm) showed normal patterns.

Conclusion

The findings of this pilot study indicate the need for larger-scale investigations, supported by advanced diagnostic modalities, to clarify the clinical relevance of exercise-induced premature ventricular complexes (PVCs) in firefighters. Although no ischemic changes were observed, the presence of subclinical coronary artery disease cannot be definitively excluded. These results provide a meaningful preliminary foundation for developing targeted screening approaches to improve early cardiovascular risk detection in high-physical-demand occupational groups.

Graphical abstract