Heart Condition Risks?

[matt215]

My dad is trying to get certified to dive on a trip we're taking next month. the problem is that he may have a heart condition that would prevent this. I'm not 100% sure about this, but I believe he may have a mild form of atrial fibrillation which is a type of arythmia. Does anyone know if diving would increase the chance of a problem happening related to this condition?
he has tests this week to determine if additional treatment is necessary, but during his class over the weekend, they wouldn't even let him in the pool for basic trainin glike assembling gear, etc...

 

[bleeb]

You may want to PM a Mod and have this thread moved to the Dive Medicine forum, where you'll probably get a better response from the medical types that hang out there. (PS. Having the thread moved is probably cleaner than starting a second thread on the same topic.)

 

[Doc Harry]

I am not a dive specialist, but I would venture an educated guess that atrial fibrillation is a definite contraindication to scuba diving. Atrial fibrillation is a symptom of rather severe heart disease (not necessarily coronary artery disease, but perhaps so). Additionally, the medications used to treat atrial fibrillation will also make it difficult for someone's heart to respond the the physical demands of scuba diving.

All in all, I would say that someone with atrial fibrillation is far from being healthy enough for scuba diving. But I would run your question by a physician who specializes in dive medicine.

 

[TSandM]

There is not enough information here to give you a good answer. Atrial fibrillation is a common disorder, and it can be due to structural heart disease or coronary artery disease, but not always. Some people are in atrial fibrillation all the time, and some have what is called paroxysmal A-fib, where they go in and out. The latter can sometimes be well-controlled with medications. A-fib in a structurally normal heart can sometimes be effectively treated with a catheter procedure that addresses the electrical abnormality that leads to the rhythm.

Chronic atrial fibrillation, especially if associated (as it often is) with a structurally abnormal heart, general means a patient with fairly poor exercise tolerance, and I would be very wary about having such a patient consider any activity where their safety might depend on the ability to exert themselves.

Your dad's doctor is the one to make the call.

Oh, and BTW, the shop was not being unpleasant by not allowing your father to participate. A positive answer on the medical screen REQUIRES a physician's statement clearing the person for dive instruction, before they can do more than listen to lectures.

 

[herbdb]

I would contact DAN and get an opinion and their recommendation for a doctor that has the background to make the call. Your GP may just say no, because he is unfamiliar with dive medicine.

 

[matt215]

the initial "symptom" appeared as several "spikes" on his ecg. he has history of hypertension that is managed (bp around 120/68 w/out meds). he wore a holter monitor for a period of time and followed up w/ ecg. that's where the "spikes" came up. this is all in dad's words so i'm sure there is something lost in translation, but from what it sounds like it's a-fib that is non-chronic in nature. he seems to be pretty ok as far as exercise goes because he works hard in the yard all day without slowing down. he's probably in better shape than i am...

 

[Dragon Eye]

Do you have a back up plan... maybe snorkeling instead?

A heart condition and diving are risks that your dad needs to assess. As much as he may want to, the LDS did the right thing and he needs clearance from a doctor.

As an additional note, check out the statistics on heart attacks under water and their survival rate.

 

[Dr. Doug Ebersole]

I'm a cardiologist and agree with ER doc Lynne (TSandM) above. There is not enough information given to make a recommendation on this specific case.

Atrial fibrillation is a very common heart rhythm abnormality and by itself does not disqualify someone from scuba diving. However, there are some conditions that lead to atrial fibrillation that could be disqualifying. In other words it is not the atrial fib but the company it keeps that is important. He should have an evaluation of his heart muscle function (echocardiogram) and some form of stress testing to assess for underlying coronary artery blockages. If he has no structural heart disease and the rhythm is well controlled with medications, there is no reason he couldn't dive. A couple of caveats --
(1) some medications used to slow atrial fibrillation (like beta blockers) can impede exercise tolerance in some people
(2) blood thinners like Coumadin used to prevent clot formation in people with atrial fibrillation make a diver more likely to bleed from barotrauma, cuts, scrapes, etc. Additionally, there is a theoretical risk of bleeding into the site of a DCS hit

Neither of these are contraindications to diving but should be considered on a case by case basis.

Hope this helps.

Doug

 

[matt215]

he has an echo and a nuclear stress test on thursday. back up plan is snorkel only. his bp is pretty ok i think, but coronary artery disease could be a bigger issue. i'm thinking positive...

 

[Dr. Doug Ebersole]

Keep us informed.