I was diagnosed with ARVD or arrythmogenic right-ventricular dysplasia a couple of years ago but do not suffer from any arrythmias and do not have any problems with stress tests. No irregular rythms show up on a holter either. I deecided to take up diving and the two heart specialists i see both said that i shouldn't. I think it is a knee-jerk, play it safe reaction. I took up diving anyway and got my PADI Open Water dive certificate last week without any problems whatsoever. Am generally fit, used to rock-climb, am not overweight and dont drink or smoke. Can anyone advise if there is a real danger if i carry on with the sport as I would very much like to do??
Arvd
- Thread starter maltaman
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Based on the above description, which doesn't include the specific objections by the cardiac specialists or a medication history, it does not appear that the condition would be an absolute contraindication to scuba.
However, the diver with ARVD should contact DAN and get their expert opinion before continuing. You or your doctor can contact DAN by calling 919-684-2948 (Monday through Friday, 9am to 5pm EST) or emailing http://www.diversalertnetwork.org/c...asp?RE=Medicine.
This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.
Best regards.
DocVikingo
However, the diver with ARVD should contact DAN and get their expert opinion before continuing. You or your doctor can contact DAN by calling 919-684-2948 (Monday through Friday, 9am to 5pm EST) or emailing http://www.diversalertnetwork.org/c...asp?RE=Medicine.
This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.
Best regards.
DocVikingo
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Well, you got a good answer from an expert. That's something to be thankful for.maltaman:
Have you emailed DAN, yet?
Saturation
Medical Moderator
Hi MM:maltaman:
I just found out that you had posted this publicly over a month ago, but sorry, didn't see it until your PM earlier this month.
ARVD is considered a rare disease, and is a problem in the future. We cannot tell when the irregular heart rhythms will strike, and worse case it could be underwater. In its early phase, one can be completely normal. In healthy young men who have suddenly died unexplicably, ARVD has been implicated. Again, its rare and not well known in the USA ... its slightly more common in Europe.
http://www.clinicaltrials.gov/ct/gui/show/NCT00024505
http://circ.ahajournals.org/cgi/content/full/107/23/2975
A consensus is that a genetic mutation alters the cells in the right side of the heart and predisposes to irregular heartbeats, and these alterations worsen with time until a point is reached that the irregular rhythms occurs. As these irregular beats can be fatal, it important the patient be routinely monitored by an expert cardiologist to see the earliest signs of rhythm abnormalities to institute protective measures.
Is diving safe? As the disease changes with time, and since we do not know much about when the irregular beats occur, diving poses added risks because rhythms that may simply lead to unconsciousness can cause death by drowning. However, this same logic also means driving a car, mountain climbing, bicycling etc., can also lead to major injuries or death should the irregular rhythm strike while the patient, seemingly healthy, is engaged in these activities. Not enough is known about the disease today to disqualify a patient from these activities until the first signs of abnormal beats occur so efforts are underway now to better understand the disease.
Whether the first abnormal beats have to occur before a preventive treatment to minimize risk of irregular rhythms is started is unknown, either as medications or an implantable defibrillator ... a judgment that has to be made between the patient and their cardiologist when to institute these, as the defibrillator itself is not without its problems.
http://circ.ahajournals.org/cgi/content/abstract/109/12/1503
Knowing that abnormal rhythms occur in this disease and it occurs without warning at anytime, means unfortunately the disease is disqualifying for diving unless an overide is given by a cardiologist.
Thanks for the comprehensive reply saturation. Im due for an MRI scan and meeting with cardiologist on the 23rd so i'll have to discuss the whole situation then. It would be a huge blow to me if I have to give it up. Malta's a tiny island with not much else to do here..
Thanks for the comprehensive reply saturation. Im due for an MRI scan and meeting with cardiologist on the 23rd so i'll have to discuss the whole situation then. It would be a huge blow to me if I have to give it up. Malta's a tiny island with not much else to do here..
maltaman:
Thanks for the comment dandydon..as you can see saturation kindly took the time to give me some good feedback. To me the issue is whether diving can actually trigger a heart problem underwater or is it a matter of the risk being that i could get an arrythmia while underwater.. Since I'm underwater for such a short time compared to me driving or climbing then the risk would be relatively tiny.
Saturation
Medical Moderator
There is a lot that is unknown about ARVD, and if one is without symptoms today, a case can be made to continue to enjoy today, the sports one wishes. However, the flip side is that without knowing when the irregular beats strike [age, change in appearance of the heart, early pre-mature heart beats, etc., anything to use as a predictor of risk], or what triggers them [food, drugs, exertion, anxiety, etc.,] it could happen while engaged in a sport, and thus make an injury more complicated than it could have been.maltaman:
This situation requires a very individualized assessment.
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