Anticoagulants and Diving

[Buadhai]

I live in Thailand. I am 73 years old. I've been diving for just over 50 years.

Last December I had an atrial fibrillation event for the first and, so far, only time. It lasted about ten minutes. Other than the rapid, irregular heartbeat I had no other symptoms and felt completely normal. I was wearing an Apple Watch so I did a single lead ECG which the watch diagnosed as atrial fibrillation. This was later confirmed by a cardiologist who looked at the ECG.

The cardiologist has prescribed Edoxaban (anticoagulant - 60mg daily) and Losartan (for hypertension - 25mg daily).

There's not a lot of information out there about diving on anticoagulants except that it's not advised. (This thread indicates that there's not much data on this: Have you dived while taking the newer anticoagulant medications?)

I hate to give up diving, but I'm having difficulty evaluating the risks.

Any advice or links to better data would be appreciated.

(BTW, the Losartan has had zero effect on my blood pressure. Since starting the medication the average is 138/76. For all of last year, the average was 134/78.)

 

[FishWatcher747]

Actually you are presenting a problem that you are not asking about. Yes anticoagulants put you at increased risk of bleeding.

The greater risk though is an episode of rapid heart rate from an episode of atrial fibrillation while diving. There is no reason it would only last seconds or minutes. It can last hours or days. This could have you be underwater with a heart rate of say 130 and a feeling like you cannot breath very well at rest. Now if you were diving with easy and prompt access to help and medical care one could possibly surface safely and get out of the water.

Diving in a remote location would be riskier.

Not giving you advice just discussing the risks.

 

[Buadhai]

Not giving you advice just discussing the risks.

Thank you. Exactly what I’m looking for.

 

[rfwoodvt]

The cardiologist has prescribed Edoxaban (anticoagulant - 60mg daily) and Losartan (for hypertension - 25mg daily)....

(BTW, the Losartan has had zero effect on my blood pressure. Since starting the medication the average is 138/76. For all of last year, the average was 134/78.)

My doctor prescribed losartan for me after my last heart attack and I questioned it because I don't have hypertension.

He explained tome that yes, the losartan is in fact a medication primarily prescribed for hypertension, but when it comes to other cardiac issues it is also used to reduce the workload on the heart.

Since my heart was severely damaged they wanted to reduce the workload my heart was doing.

In my case, like yours, it has not had any substantial effect on blood pressure.

That was 12 years ago. I think it's probably doing the job as intended. LOL

Is it possible they prescribed the losartan as an adjunct to reducing the work load on your heart so as not to trigger afib?

 

[Hojo in SC]

I would contact DAN with more experienced medical experts in the field of diving.

 

[rfwoodvt]

I would contact DAN with more experienced medical experts in the field of diving.

I've done that on several occasions and almost without exception Dan says, " you really need to consult your physician"

Which obviously is no help because told my doctor I would check with to Dan to find out the implications via diving

 

[Robert H. Diver]

@Duke Dive Medicine

 

[Buadhai]

Is it possible they prescribed the losartan as an adjunct to reducing the work load on your heart so as not to trigger afib?

I don’t think so. He specifically said that it was to reduce blood pressure. He also did an echo cardiograph which showed that my heart and arteries are normal and show no sign of damage. I’ve never had a heart attack or symptoms thereof.

I will see him next week to discuss the blood pressure issue and ask about Losartan and AF.

This morning my blood pressure was higher than I’ve ever seen it: 146/79.

 

[bletso]

The biggest problem with Afib is stroke and that is why they prescribe an anticoagulant such as Eliquist, warfarin, (Coumadin) or some other anticoagulant..

 

[Buadhai]

The biggest problem with Afib is stroke and that is why they prescribe an anticoagulant such as Eliquist, warfarin, (Coumadin) or some other anticoagulant..

I fully understand that. As of now I don't feel that I have enough information to decide whether I can continue diving given the following:

• Atrial Fibrillation
• Hypertension (Level 2)
• Edoxaban (anticoagulant)

We have a live aboard trip scheduled (deposit paid) for late February. I'm inclined to cancel that now as I can probably get the deposit back.

The worst of this is the uncertainty and concomitant anxiety (and downright fear). I've never had any serious medical issues. This is the fist time since childhood that I've been prescribed medication.

I've been fortunate. Now I don't know what to do.