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The dive response is triggered by sudden submergence of the face in cold water, which stimulates the trigeminal nerve receptors around the nose. As water temperature decreases, stimulation of the receptors is enhanced and the severity of the bradycardia increases. Enhanced stimulation of these receptors results in an inhibition of the cardiovascular center, as well as a subsequent reduction in heart rate through both enhanced parasympathetic output and reduced sympathetic output to the heart. Interestingly, initiation of the dive reflex can be used to restore sinus rhythm in patients with paroxysmal supraventricular tachycardia.
This review will involve discussing normal cardiovascular physiology and autonomic reflexes.