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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">mes</journal-id><journal-title-group><journal-title xml:lang="ru">Экстремальная биомедицина</journal-title><trans-title-group xml:lang="en"><trans-title>Extreme Medicine</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">3033-8964</issn><issn pub-type="epub">3033-8972</issn><publisher><publisher-name>Centre for Strategic Planning of the Federal Medical and Biological Agency</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.47183/mes.2025-424</article-id><article-id custom-type="elpub" pub-id-type="custom">mes-424</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>СПОРТИВНАЯ МЕДИЦИНА</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>SPORTS MEDICINE</subject></subj-group></article-categories><title-group><article-title>Влияние заплывов в ледяной воде на проводящую систему сердца и вегетативную регуляцию У пловцов зимнего плавания</article-title><trans-title-group xml:lang="en"><trans-title>Impact of ice‑water swims on cardiac conduction and autonomic regulation in winter swimmers</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0524-2933</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Баранова</surname><given-names>Т. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Baranova</surname><given-names>T. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Баранова Татьяна Ивановна, д-р биол. наук, доцент</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Tatiana I. Baranova, Dr. Sci. (Biol.), Associate Professor</p><p>St. Petersburg</p></bio><email xlink:type="simple">baranovati@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3717-1271</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Украинцева</surname><given-names>Ю. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Ukraintseva</surname><given-names>Yu. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Украинцева Юлия Валерьевна, канд. биол. наук</p><p>Москва</p></bio><bio xml:lang="en"><p>Yulia V. Ukraintseva, Cand. Sci. (Biol.)</p><p>Moscow</p></bio><email xlink:type="simple">ukraintseva@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0006-5105-2830</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Карпова</surname><given-names>М. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Karpova</surname><given-names>M. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Карпова Мария Александровна</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Maria A. Karpova</p><p>St. Petersburg</p></bio><email xlink:type="simple">fox.atforest@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0006-8966-3987</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рыбьякова</surname><given-names>Т. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Rybyakova</surname><given-names>T. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Рыбьякова Татьяна Всеволодовна, канд. пед. наук, доцент</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Tatiana V. Rybyakova, Cand. Sci. (Ped.), Associate Professor</p><p>St. Petersburg</p></bio><email xlink:type="simple">t.rybyakova@lesgaft.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0007-1250-5435</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ванькова</surname><given-names>А. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Vankova</surname><given-names>A. D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ванькова Анна Дмитриевна</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Anna D. Vankova</p><p>St. Petersburg</p></bio><email xlink:type="simple">st085211@student.spbu.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0003-2970-129X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Толеген</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Tolegen</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Толеген Айжан Айтбайкызы</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Aizhan A. Tolegen</p><p>St. Petersburg</p></bio><email xlink:type="simple">aytbayevna@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2359-1814</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тарасова</surname><given-names>М. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Tarasova</surname><given-names>M. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Тарасова Мария Сергеевна</p><p>Москва</p></bio><bio xml:lang="en"><p>Maria S. Tarasova</p><p>Moscow</p></bio><email xlink:type="simple">tarasovams@sportfmba.ru</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7074-5337</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Оганнисян</surname><given-names>М. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Ogannisyan</surname><given-names>M. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Оганнисян Мкртыч Гагикович, канд. биол. наук</p><p>Москва</p></bio><bio xml:lang="en"><p>Mkrtich G. Ogannisyan, Cand. Sci. (Biol.)</p><p>Moscow</p></bio><email xlink:type="simple">ogannisyanmg@sportfmba.ru</email><xref ref-type="aff" rid="aff-4"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Санкт-Петербургский государственный университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Saint Petersburg State University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Институт высшей нервной деятельности и нейрофизиологии Российской академии наук</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Institute of Higher Nervous Activity and Neurophysiology of Russian Academy of Sciences</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Национальный государственный Университет физической культуры, спорта и здоровья им. П.Ф. Лесгафта</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Lesgaft National State University of Physical Education, Sport and Health</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>Национальный центр спортивной медицины Федерального медико-биологического агентства</institution><country>Россия</country></aff><aff xml:lang="en"><institution>National Center for Sports Medicine of the Federal Medical and Biological Agency</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>10</day><month>06</month><year>2026</year></pub-date><volume>28</volume><issue>2</issue><fpage>215</fpage><lpage>225</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Баранова Т.И., Украинцева Ю.В., Карпова М.А., Рыбьякова Т.В., Ванькова А.Д., Толеген А.А., Тарасова М.С., Оганнисян М.Г., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Баранова Т.И., Украинцева Ю.В., Карпова М.А., Рыбьякова Т.В., Ванькова А.Д., Толеген А.А., Тарасова М.С., Оганнисян М.Г.</copyright-holder><copyright-holder xml:lang="en">Baranova T.I., Ukraintseva Y.V., Karpova M.A., Rybyakova T.V., Vankova A.D., Tolegen A.A., Tarasova M.S., Ogannisyan M.G.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.extrememedicine.ru/jour/article/view/424">https://www.extrememedicine.ru/jour/article/view/424</self-uri><abstract><sec><title>Введение</title><p>Введение. Зимнее плавание как вид спорта отличается от классического плавания и плавания в открытой воде экстремальной холодовой нагрузкой на организм. При заплывах в холодной воде с погружением лица в воду реализуется нырятельная реакция, которая в условиях низких температур может сопровождаться формированием сердечных аритмий. Мы полагаем, что для допуска к занятиям холодовым плаванием необходима разработка специальных критериев.</p></sec><sec><title>Цель</title><p>Цель. Изучение особенностей изменений состояния сердечно-сосудистой, нервной систем, вегетативной регуляции и метаболических показателей у пловцов зимнего плавания при температуре воды от +0,5 до +2,0 °С на различных дистанциях и 10-минутном заплыве на 450–550 м.</p></sec><sec><title>Материалы и методы</title><p>Материалы и методы. В условиях соревновательной деятельности и учебно-тренировочных сборов (при температуре воды от +0,5 до +1,5 °С, температуре воздуха от -15 до -18 °С) проведено обследование 24 спортсменов зимнего плавания: 9 женщин (23–55 лет; средний возраст 39,1 ± 2,7 года); 3 мужчин в возрасте 71 ± 3 года; 12 мужчин (35–60 лет; средний возраст 43,0 ± 1,8 года), имевших медицинский допуск к занятиям. Состояние испытуемых анализировали до и после заплывов на дистанциях 25 м кролем на спине, 25 и 200 м вольным стилем на груди и после 10-минутного заплыва на 400–450 м. Для оценки функционального состояния проведены: электрокардиография в 12 отведениях, измерение артериального давления, определение концентрации глюкозы в капиллярной крови, определение простой сенсомоторной реакции на световой раздражитель. Статистический анализ для выявления различий между показателями выполнен с использованием пакета программного обеспечения GraphPad Prism 8 для Windows 10.</p></sec><sec><title>Результаты</title><p>Результаты. Установлено статистически значимое повышение среднегрупповых показателей уровня глюкозы в капиллярной крови после заплывов на 25 м (p &lt; 0,05), 200 м (p &lt; 0,01) и 400 м относительно исходного состояния; увеличение времени простой сенсомоторной реакции после 10-минутных заплывов: в исходном состоянии 263 ± 10 и 328 ± 21 мс после заплыва (p &lt; 0,01). По данным ЭКГ в исходном состоянии у 67% обследованных выявлено уширение зубца Р &gt; 0,11 мс. После заплывов на короткие дистанции 25 м длительность зубца Р выходит за верхний предел нормы у 85% обследованных. По сравнению с заплывами на спине заплывы с погружением лица в воду сопровождались достоверно более выраженным уширением зубца Р (p &lt; 0,05), замедлением проведения через предсердия — PQ (p &lt; 0,01), более выраженным увеличением QTc показателя (p &lt; 0,05). Величина QTc прогрессирующе увеличивается в соответствии с длительностью заплывов. При 10-минутном заплыве у 50% обследованных QTc &gt; 500 мс.</p></sec><sec><title>Выводы</title><p>Выводы. Низкая температура воды — фактор, который даже у адаптированных к холоду спортсменов провоцирует стресс, сопровождающийся повышением глюкозы в крови. При заплывах с погружением лица в воду реализуется нырятельный рефлекс, который в холодной воде может провоцировать сердечные аритмии. При заплывах на длинные дистанции происходит замедление проведения в нервной системе, что отражается в увеличении времени простой сенсомоторной реакции и замедлении проводимости миокарда, достигающего патологического значения. В связи с этим считаем, что для новичков, желающих заниматься холодовым плаванием, во избежание риска патологического ответа сердечно-сосудистой системы необходима разработка и введение в практику допуска дополнительного критерия — оценки реакции сердечно-сосудистой системы на водно-холодовую иммерсию.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Introduction</title><p>Introduction. As a kind of sport, winter swimming differs from pool- or open-water swimming due to the extreme cold stress it places on the body. Swims in cold water with facial immersion trigger a diving reflex, which may be accompanied by the development of cardiac arrhythmias under low-temperature conditions. We believe that specific criteria should be developed for permitting individuals to engage in cold-water swimming.</p></sec><sec><title>Objective</title><p>Objective. Study of the characteristics of changes in the state of the cardiovascular and nervous systems, autonomic regulation, and metabolic parameters in winter swimmers at water temperatures from +0.5 °C to +2.0  °C both over various standard distances and during a 10-min swim of 450–550 m.</p></sec><sec><title>Materials and methods</title><p>Materials and methods. Under competitive conditions and during training camps (at water temperatures from +0.5 °C to +1.5 °C and air temperatures from –15 °C to –18 °C), 24 winter swimmers were examined. These were 9 women aged 23–55 (mean age 39.1 ± 2.7 years); 3 men aged 71 ± 3 years; and 12 men aged 35–60 (mean age 43 ± 1.8 years), all of whom had received medical clearance for participation. The participants’ condition was analyzed before and after swims at distances of 25 m backstroke, 25 m and 200 m front crawl (freestyle), as well as after a 10-min swim of 400–450 m. The functional state of the body was assessed using 12-lead electrocardiography, blood pressure measurement, determination of capillary blood glucose concentration, and assessment of simple sensorimotor reaction to a light stimulus. Statistical analysis to identify differences between parameters was performed using the GraphPad Prism 8 software package for Windows 10.</p></sec><sec><title>Results</title><p>Results. A statistically significant increase in the mean capillary blood glucose levels was observed after swims of 25 m (p &lt; 0.05), 200 m (p &lt; 0.01), and 400 m compared to the baseline. An increase in the simple sensorimotor reaction time after 10-min swims was noted; thus, the baseline of 263 ± 10 ms vs. 328 ± 21 ms after the swim (p &lt; 0.01). According to ECG data, at baseline, 67% of the examined individuals showed a widened P wave &gt; 0.11 ms. After short-distance swims of 25 m, P wave duration exceeded the upper limit of normal in 85% of the examined. Compared to backstroke swims, swims with facial immersion in water were accompanied by a significantly more pronounced widening of the P wave (p &lt; 0.05), slowing of atrial conduction PQ (p &lt; 0.01), and a more pronounced increase in the QTc interval (p &lt; 0.05). The QTc value progressively increased in accordance with the duration of the swims. During a 10-min swim, 50% of the examined individuals showed a QTc &gt; 500 ms.</p></sec><sec><title>Conclusions</title><p>Conclusions. Low water temperature is a factor that, even in cold-adapted athletes, provokes stress accompanied by an increase in blood glucose. During swims in cold water with facial immersion, the activated diving reflex triggers cardiac arrhythmias. During long-distance swims, conduction in the nervous system slows down, manifested in an increased simple sensorimotor reaction time and slowed myocardial conduction, reaching pathological values. In this regard, we believe that an additional criterion for medical clearance — assessment of the response of the cardiovascular system to cold-water immersion — should be developed and implemented for beginners wishing to engage in cold-water swimming, in order to avoid the risk of a pathological cardiovascular reaction.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>холодовое плавание</kwd><kwd>нервная система</kwd><kwd>сердечно-сосудистая система</kwd><kwd>автономная регуляция</kwd><kwd>сердечные аритмии</kwd><kwd>внутрисердечное проведение</kwd><kwd>гипертензивный ответ</kwd><kwd>сенсомоторная реакция</kwd><kwd>водно-холодовая иммерсия</kwd></kwd-group><kwd-group xml:lang="en"><kwd>cold-water swimming</kwd><kwd>nervous system</kwd><kwd>cardiovascular system</kwd><kwd>autonomic regulation</kwd><kwd>cardiac arrhythmias</kwd><kwd>intracardiac conduction</kwd><kwd>hypertensive response</kwd><kwd>sensorimotor reaction</kwd><kwd>cold-water immersion</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">исследование выполнено в рамках научно-исследовательской работы ФГБОУ ВО «Санкт-Петербургский государственный университет» по теме «Адаптация организма человека к экстремальным факторам среды» № 46195617.</funding-statement><funding-statement xml:lang="en">the research was conducted within the framework of the scientific research work of the Saint Petersburg State University on the topic “Human Adaptation to Extreme Environmental Factors” No. 46195617.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Podyacheva E, Zemlyanukhina T, Shadrin L, Baranova T. 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