Atrial Fibrillation

[emoreira]

Perhaps Doug can also elaborate on the issue of beta blockers and diving. I seem to recall that they can reduce exercise tolerance and that the ability to achieve 13 mets without fatigue was necessary to be approved for diving. But this could all be old info since I do not take a beta blocker anymore.

The last ergometry I did, my score was 11 METs.
The cardiologist and electrophysiologist both said that the result was excellent.
I do not recall ever read or seen that any METs score was required to practice scuba, and if this would be true and in force, I guess that more than 75 % of all divers worldwide should remain at home. Even further, this was also not mentioned in the SSI DCS requirements and only a watermanship test and a doctor clearance were required.
11 METs, my score, was 88 % of the max value for my age (54), so if I would have achieved the maximum of the Bruce protocol, my score would have been 12,5 METs.

Are my METs the same that those you mention ?

 

[Dr. Doug Ebersole]

Thanks, Ken for alerting me to the new posts. It's good to hear that you have done well and are now on a beta blocker, Bisoprolol, alone. It is unlikely that the low dose you are taking would have any impact on your exercise tolerance so it should definitely not be a contraindication to diving. I would also agree that should you have recurrent atrial fib, it would be reasonable to seek out an electrophysiologist with a great deal of experience in atrial fibrillation ablation for his or her opinion on the risks/benefits of the procedure for you as an individual.

Just an FYI. Most people do not have significant decrease in their exercise tolerance on beta blockers unless they are on a high enough dose so that they can no longer achieve appropriately high heart rates with exercise. However, there are always exceptions. Poor exercise tolerance due to easy fatigability associated with a blunted heart rate response to exercise would be a relative contraindication to diving -- on a case by case basis. The "13 mets" number is usually used when discussing people with coronary artery disease and diving. For those patients it is recommended that they be able to achieve 13 mets on stress testing or be able to sustain 6.5 mets -- something like walking 2 miles in 20-25 min.

 

[emoreira]

The last ergometry I did, my score was 11 METs.
The cardiologist and electrophysiologist both said that the result was excellent.
I do not recall ever read or seen that any METs score was required to practice scuba, and if this would be true and in force, I guess that more than 75 % of all divers worldwide should remain at home. Even further, this was also not mentioned in the SSI DCS requirements and only a watermanship test and a doctor clearance were required.
11 METs, my score, was 88 % of the max value for my age (54), so if I would have achieved the maximum of the Bruce protocol, my score would have been 12,5 METs.

Are my METs the same that those you mention ?

Just to mark my error, the 13 METs rate required is mentioned in the RSTC MEDICAL STATEMENT, which can be downloaded from here.
As mentioned in the post, my average score was 11 METs, however in stage 4 of the Bruce Protocol my score was 13 so I'm cleared for diving.
More than 6 months have passed from the last medical review and it's time for a new review, just for control. The cardiologist ordered a full blood and urine analysis (already done and both ok), an Eco-cardiogram and an Ergometry.
Since the AFib event no new event happened and I went on with my normal life. Exercise was increased, fixed bike, swimming and now running.