Diving after Ablation for AFib and Flutter

[Duke Dive Medicine]

The replies you have gotten are from some very learned folks. That said, please remember the highest diving deaths per age group is 50-59 and the second highest 60-69 with fewer from 70-79 because few 70-79 year olds dive. Next, the second highest cause of diving deaths, after drowning, is cardiac arrest. Many of those drownings are cardiac related. So, what I will say will offend you but just because you can climb one mountain on a certain day doesn't mean you won't eat a **it sandwich and die the first time you dive because of cardiac arrest. What is your resting heart rate? What is your max heart rate? Have you had a stress test in the last six months? What is your BMI? Can you run 3 miles without stopping? I'm 55 and run 5 miles a day or bike 20 at least 5 days a week and have a resting heart rate in the 40s and diving can be tough. I road a 145 mile bike race six weeks ago and if I hadn't separated my shoulder in a 24 mph bike crash would have run a 1/2 marathon and done three other long bike races already this summer. If you're not in shape and especially if you've had heart problems don't dive. Just don't. It's not worth it. In Key Largo in March I had a dive instructor telling me how many 50 somes they'd seen die at the end of a dive trying to get back in the boat. I see way to many people diving that shouldn't be because they are overweight and out of shape let alone have heart problems. Call us back when you are running 5 miles a day 5 days a week, had a stress test, and are cleared by your cardiologist to dive.

Are you addressing the OP from November 2020, for whom a couple of us had legitimate concerns, or @Viso, who posted today at noon and seems to be well on the way to recovery? Either way, blanket advice to achieve the level of cardiovascular fitness you're describing prior to diving, especially in the setting of cardiac anomalies, is neither prudent nor realistic. Cardiac fitness to dive is an individual conversation between the prospective diver, the cardiologist, and if deemed necessary, a physician trained and experienced in evaluating divers.

You mentioned the 13 mets / 7 1/2 minute criteria in another post, though from that post it seems like you're saying that 7 1/2 minutes of jogging will achieve 13 mets, which is not necessarily the case, e.g. at your professed level of fitness, you would not be at 13 mets after 7 1/2 minutes of jogging. Bove's original recommendation was to achieve 13 mets and sustain it for 7 1/2 minutes. Nuanced, but different. At any rate, this is not aligned with current recommendations for average recreational diving (sustained activity at 6 mets), though you'll still see it cited from time to time.

Best regards,
DDM

 

[okrunner]

I was addressing the OP from November 2020. Sorry about any confusion there. Maybe this whole issue hit home as just last weekend I dove with an instructor working with students who is cross certified in PADI, NAUI, SSI, etc. etc. etc. with thousands of dives all over the world in all kinds of disciplines including instructing and commercial. He's vastly more experienced than I am or most for that matter. Nonetheless, he has had two open heart surgeries and three months ago had a pacemaker put in. He is overweight and I watched him struggle just to get his booties on. I questioned him as to whether he should be diving and he insisted. I'm very concerned for him. He wants to go again soon. I think he knows the risks. Personally, I just don't think he cares if he strokes out while diving. To each his own I guess. There's even more to the story but we're on a public forum. But for some, I don't think they fully grasp the enormous pressure put on the human body not only by the "pressure itself" but the excursion of diving. As to a comment above about how many people an instructor in Florida would see die, well, Florida averages about 20 diving deaths a year and there aren't that many operators so plenty of instructors have seen a few deaths there if you've worked there very long. Anyway, maybe I was harsh but maybe because I'm worried about a friend.

 

[ofg-1]

Wow! You guys have really opened my eyes here. I would have never thought that older people are at higher risk of dying than younger people. That a 70 yo (like me) is closer to death than a 30 yo. Next, you will want me to believe that a couch potato that lives on lardburgers, twinkies and diet Mountain Dew is more likely to die than a vegan cross country bike rider. I am gobsmacked by this important information. Someone should do a study.

BTW, I thought mets were a New York baseball team.

 

[Duke Dive Medicine]

I was addressing the OP from November 2020. Sorry about any confusion there. Maybe this whole issue hit home as just last weekend I dove with an instructor working with students who is cross certified in PADI, NAUI, SSI, etc. etc. etc. with thousands of dives all over the world in all kinds of disciplines including instructing and commercial. He's vastly more experienced than I am or most for that matter. Nonetheless, he has had two open heart surgeries and three months ago had a pacemaker put in. He is overweight and I watched him struggle just to get his booties on. I questioned him as to whether he should be diving and he insisted. I'm very concerned for him. He wants to go again soon. I think he knows the risks. Personally, I just don't think he cares if he strokes out while diving. To each his own I guess. There's even more to the story but we're on a public forum. But for some, I don't think they fully grasp the enormous pressure put on the human body not only by the "pressure itself" but the excursion of diving. As to a comment above about how many people an instructor in Florida would see die, well, Florida averages about 20 diving deaths a year and there aren't that many operators so plenty of instructors have seen a few deaths there if you've worked there very long. Anyway, maybe I was harsh but maybe because I'm worried about a friend.

I would be concerned too. It sounds like you've talked with him about it - did he get clearance to dive from his cardiologist and cardiac surgeon? Does he recognize that if he has a cardiac event under water, people may risk their own lives to save him and could be traumatized by witnessing an accident?

Best regards,
DDM

 

[Viso]

In most (not all) ablations, the septum dividing the right and left sides of the heart is pierced. You essentially get a temporary PFO. It needs time to heal over, and that is a matter of months. Are you going to get a echocardiogram with bubbles? If so, that will tell you if the hole has healed.

The echocardiogram was mentioned as a proof of the closure of the perforation.

 

[okrunner]

I would be concerned too. It sounds like you've talked with him about it - did he get clearance to dive from his cardiologist and cardiac surgeon? Does he recognize that if he has a cardiac event under water, people may risk their own lives to save him and could be traumatized by witnessing an accident?

Best regards,
DDM

He avoided discussing the issue. I'm going to speak with him further on it. Luckily, I'm heading to the Keys next week and he won't be doing anything until late July at the earliest so I have some time to talk to him.