10. Summary
In summary, swimming is a popular sport worldwide amongst people
of all ages. Its popularity primarily rests in its low impact nature,
which makes it an attractive option for patients with joint diseases,
who cannot tolerate land exercises. As compared to other forms of aerobic
exercise, swimmers attain lower VO2max, associated with lower
arterio-venous oxygen differences, and similar cardiac output characterized
by lower heart rate, and greater stroke volume. Left ventricular
dilatation, normal wall thickness to dimension ratio, and increased
stroke volume with normal diastolic filling characterize the cardiac
adaptations to swim training. The evidence is emerging to suggest
that swimming is comparable to land exercises in its effect on cardiovascular
risk factors,most notably blood pressure reduction. In addition,
its use in cardiac rehabilitation programs, particularly in patients with
stable CAD and CHF, appears to be well tolerated. Controlled pool conditions,
particularly withwarmer temperatures appear to be important.
As in all forms of exercise, activity in moderation and under the supervision
of healthcare providers is advised in this population. In addition,
exercise prescriptions with specific attention to heart rate monitoring
may be needed given the evidence of a possible asymptomatic, lower
ischemic threshold for these patients. Lastly, in patients with a history
of LQTS, particularly if there is genetic verification, swimming should
be avoided because of the increased risk of a cardiac event.