DAN researchers surveyed divers with implanted cardiac devices, like pacemakers. This study established their health history, diving practices and incidence of adverse events during and after scuba diving.
This study concluded that patients with implantable cardiac devices who continue to scuba dive have significant cardiac histories, high rates of pacemaker dependence, aggressive diving practices and appreciable complication rates.
This survey was completed in 2014.
Implanted cardiac devices, including pacemakers and cardioverter-defibrillators, are standard treatment for subjects with various forms of arrhythmias that would otherwise be contraindications for recreational scuba diving. Implantable cardioverter-defibrillators are implanted for the primary and secondary prevention of sudden cardiac death due to potential lethal arrhythmias including ventricular tachycardia (VT) and ventricular fibrillation (VF). As the technology advances, these devices are being used more frequently.
Patients with implantable devices are often highly functional and want to pursue activities such as recreational diving without restriction. However, the effects of diving on implantable devices are not well-studied. Prior studies have identified device geometric distortion and device-triggered increases in heart rate that occur at pressures consistent with recreational dive limits. Implanted devices vary markedly in their tolerance of increased pressure. Moreover, patients with implanted devices have a higher potential for concerning symptoms such as syncope, pre-syncope, dizziness, congestive heart failure, mental confusion, palpitations, shortness of breath, exercise intolerance or cardiac arrest.
Despite these concerns, there have been no clinical studies on the effects of diving on implantable cardiac devices. Diving with such a device is generally not recommended given the risk of drowning due to a possible underwater electrical shock. However, some divers go against medical advice. This survey gathered information on demographics, cardiac history, implantable device characteristics, symptoms, diving practices, complications from a large cohort of divers with implantable cardiac devices, and pre-diving medical evaluation and education received in subjects with implantable cardiac devices. This study was conducted in cooperation with researchers from Virginia University.
This study concluded that patients with implantable cardiac devices who continue to scuba dive have significant cardiac histories, high rates of pacemaker dependence, aggressive diving practices and appreciable complication rates.
Additional Reading and References
Conference Contributions
- Bourque JM, Ranapurwala SI, Denoble PJ. Divers with Implantable Cardiac Devices: Clinical Characteristics and Variations in Diving Practice. UHMS annual scientific meeting (2014).
- Divers with Implantable Cardiac Devices: Clinical Characteristics and Variations in Diving Practice