Autonomic Conflict and Cardiac Arrhythmias During Cold Water Immersion
How does autonomic conflict during cold water immersion cause dangerous heart rhythms?
Autonomic conflict occurs when cold water simultaneously triggers opposing nervous system responses - the diving reflex slows the heart while cold shock accelerates it, creating electrical instability that can cause fatal arrhythmias within 2-5 minutes of immersion.
This phenomenon represents a critical but under-recognized mechanism of sudden death in cold water. Unlike gradual hypothermia, autonomic conflict can kill rapidly through cardiac electrical disturbances, even in strong swimmers and healthy individuals. Understanding these mechanisms is essential for preventing cold water tragedies.