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Diving after Pacemaker Implant

After surveying divers who had implanted cardiac devices, research by DAN® addresses the risks associated with the adverse events of scuba diving with pacemakers.

This guide contains information that answers the question of whether it is safe to start scuba diving - or continue - after having a cardiovascular pacemaker insertion.

Response by the Diver Alert Network [DAN]

In days gone by, the overly conservative approach to this question was less complicated.

In fact, the answer would have been a blanket statement of something like:

"Anyone who has a cardiovascular pacemaker in place should never go scuba diving again!"

In point of fact, a cardiac pacemaker is invariably considered as being an outright disqualification in military and commercial diving.

Then what about sport divers? The medical literature that has become available takes a more rational approach. In other words, each individual should be medically evaluated on a case by case basis.

Nevertheless, there are two important factors that must be taken into account, namely:

  1. Why is the individual dependent on a cardiac pacemaker device?
  2. Is the pacemaker rated to perform at depths (pressures) that make it compatible with recreational scuba diving. It's also important to add a margin of safety.

As with any medical device, and most medications, the underlying problem is likely to determine someone's fitness to participate in scuba diving. Thus, the same medical guidelines exist after a scuba diver has a cardiac pacemaker implanted.

Pro Tip: For the most part, the insertion of a permanent pacemaker will indicate some kind of serious disturbance in the actual conduction system of the heart.

Assessing Cardiovascular Fitness to Dive

So, what if the damage has caused a problem with the heart muscle? In fact, this is often the case if a scuba diver suffers a severe heart attack.

If this is the case, the individual may lack sufficient cardiovascular fitness (e.g. 7 METs activity) needed to perform basic tasks in the water.

Here's the thing:

Some divers will be dependent on a cardiac pacemaker because of an identified rhythm disturbance or some kind of chronic abnormality in the conduction system.

This will affect the area of the heart that generates electrical impulses. Hence, there may be some disturbance to the mechanical contraction that shifts the blood. The result may be inconsistent or inadequate function.

Plus, the circuitry that conducts the heartbeat may also be faulty. The most likely outcome would be improper or irregular conducted signals.

For these reasons, without the medical assistance of an artificial cardiac pacemaker, a person may suffer syncopal episodes (fainting or passing out).

DAN Advice: After addressing all cardiovascular issues, and confirming that the pacemaker can detect arrhythmia and is rated to at least six (6) atmospheres, a diver who can exercise to a minimum of 7 km/h on a treadmill may be able to go scuba diving after a pacemaker implant.

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