Pacemakers at Depth?

[resqsqurt]

I have a pacemaker and (obviously) I am a diver. I know to contact the manufacturer, which I have done, and all of the other basic recommendations on how shallow we need to dive, etc, etc. I also know that we have to take into consideration the underlying condition requiring the pacemaker.

My question: Is there anyone here who has a pacemaker and has been diving with it? How deep have you gone and have you had any problems?

The manufacturers make recommendations, but are they necessary? Are the manufacturers just doing "CYA" statement or do we need to be really careful? Are they simply trying to avoid liability? I'm not talking about being a tec diver and going to 240'; I am referring to staying purely within recreational limits and NEVER exceeding 130'.

My pacemaker company guarantees the sensors to 60 FSW. Hyperbaric testing was performed to 165' with no residual dysfunction. However, according to the tests, the box can begin to deform at "pressures approaching 132'." BUT, even at 165', it still works fine when functions were checked after the hyperbaric testing. Their ultimate recommendation is to stop at 100 FSW.

I was at 107' last week and did not have any problems. Does anyone else have any anecdotal experience they would be willing to share with me?

 

[resqsqurt]

I spoke with a representative from my pacemaker manufacturer the other day. She said that the company has no specific plans to make a more durable pacemaker. However, they are beginning to do more testing to determine if these pacemakers might be able to withstand greater pressures and, therefore, greater depths. If and when I hear anything else from them, I will post the information for anyone who might be interested.

 

[Saturation]

As a rule pacemakers function within the range of recreational diving ... as diver would have to get clearance from their cardiologist and verify a pacers capabilities with the manufacturer as the specific pacemaker isn't just the only issue, a bigger issue is why the pacemaker has been placed in the first place.

http://www.scuba-doc.com/pace.htm

http://www.diversalertnetwork.org/medical/faq/faq.asp?faqid=143

 

[underwaterangel]

I had a pacemaker implanted in July. I am 35. My heart stopped (several times) for no apparent reason. The doctors could not find a cause. My cardiololgist cleared me to dive with no restrictions. When I contacted the company, I was told it was ok to 2.5 ata in a hyperbaric chamber. Rather unsure how to proceed at this point....

 

[Saturation]

I had a pacemaker implanted in July. I am 35. My heart stopped (several times) for no apparent reason. The doctors could not find a cause. My cardiololgist cleared me to dive with no restrictions. When I contacted the company, I was told it was ok to 2.5 ata in a hyperbaric chamber. Rather unsure how to proceed at this point....

The bolded item above is one reason to contact a dive physician in your area, you can find them by calling DAN or to let your cardiologist touch base with them.

1st off, while recreational diving extends to 120-130' max depth, based on the above note the specific pacemaker placed is rated to only 50.' Many modern pacemakers are typically advised not to be taken below 30'.

Alas, this has been a trend in modern pacemakers in that the depth rating has been much less than prior older models and depth rating varies from model to model, and manufacturer.

 

[DocVikingo]

"J Interv Card Electrophysiol. 2006 Apr;15(3):179-83.

Activity-based rate-adaptive pacemakers under hyperbaric conditions.

Trigano A, Lafay V, Blandeau O, Levy S, Gardette B, Micoli C.

Department of Cardiology, Centre Hospitalier Universitaire Nord, 13915 cedex 20, Marseille, France, alexandre.trigano@mail.ap-hm.fr.

OBJECTIVES: The aim of this study was to test a variety of currently available activity-based rate-adaptive pacemakers under hyperbaric conditions. BACKGROUND: Sports divers with pacemakers can dive under certain circumstances. The rate response of activity-sensing pacing under hyperbaric conditions has rarely been evaluated.

MATERIALS AND METHODS: We manufactured a miniaturized hyperbaric chamber. A pacemaker inside was kept close to the corresponding telemetry wand placed on top of the chamber. An inflation device for coronary balloon angioplasty was used to create hydraulic pressure. Group I pacemakers were exposed to a 30 msw/98 fsw/4 ATA and after a 1-month waiting period to 60 msw/197 fsw-depth/7 ATA. Group II was exposed to only one dive to 60 msw. The electrogram and event marker telemetry were used to monitor the pacing stimuli and measurements were made for case distortion.

RESULTS: The baseline pacing rate did not change in 27 tests. Return to baseline was shown during 18 tests after transient sensor-driven rate. There was a sensor rate response to manual brief shaking during and following testing. A case distortion was shown in 15 of 29 tests at 60 m.

CONCLUSIONS: Modern accelerometers showed no sensitivity to pressure on the pacemaker can at 30 msw/98 fsw and 60 msw/197 fsw but in some devices responded to pressure changes. There was no pacing dysfunction or suppression of the sensor response despite the high incidence of case distortion at 60 msw/197 fsw. As a general rule, diving should not be allowed at depths greater than 20 msw/65 fsw."

Regards,

DocVikingo

 

[Saturation]

Thanks DV for posting the abstract. I think that's the latest in Medline so far. I haven't read the actual paper but if you go to a specific manurfacturer site and check a particular model, often they mention operating ranges from 0.5 -2.0 ATA.