Wolf Parkinsons White (WPW) and diving?

[Ber Rabbit]

I know an individual with Wolf Parkinsons White who would like to learn to dive. What he explained to me is that he basically has 2 natural "pacemakers" in his heart and sometimes even when he's resting his heart will race due to the extra "pacemaker." He has not had it fixed, the cardiologists told him that as long as it wasn't bothering him he would not need to fix it. He said he has never had any episodes where he lost consciousness.

I don't think diving is a good sport for him but I'm having trouble convincing him why. He's still young and bulletproof and thinks all doctors are quacks. Can someone please help?

Thanks in advance!
Ber :lilbunny:

 

[Dr. Doug Ebersole]

I'm a cardiologist with an interest in diving medicine. The consensus opinion for diving with WPW (Wolf-Parkinson-White) Syndrome is that it is a disqualifying condition for diving if it is symptomatic. As you friend is asymptomatic he could be allowed to dive though it is recommended that he have a exercise stress test prior to beginning diving to verify that he doesn't develop any rhythm abnormalities with exercise.

 

[Ber Rabbit]

He said he can be sitting down doing nothing and his heart will start to race--isn't that symptomatic even though it doesn't "bother" him enough to make him want to go out and have it fixed?

If he were to have the ablation would he be a candidate for diving?
Ber :lilbunny:

 

[TSandM]

The big danger with WPW is a heart rate rapid enough that the heart cannot efficiently pump enough blood to support the patient. It may sound odd, but if the heart beats fast enough, there is not enough time between contractions for it to fill back up, and the amount of blood circulated actually decreases. This typically results in lightheadedness, shortness of breath, feeling sweaty and weak, or loss of consciousness. Having any of these would be considered symptomatic. Merely being aware of a faster heart rate would not.

There are medications that can control the tachycardias in many patients. I had a very good friend years ago who kept his under control by remaining in such good physical condition that his vagal tone kept his heart rate low. And ablation of the accessory pathway can solve the problem altogether.

I would be very nervous about approving someone with WPW who was having tachycardic episodes to go underwater.

 

[Dr. Doug Ebersole]

PM received and reply sent.

As a practicing cardiologist as well as a scuba diving instructor, I would definitely NOT clear anyone with symptomatic WPW to dive, even if controlled on meds. However, if the accessory pathway is able to be identified at EP study and ablated, that is another story.

 

[Benthos]

PM?'s

This is a VERY interesting topic. I would be thrilled to hear about any opinions or literature you find.