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Can a person dive with a pacemaker?

Michael Fitzgerald   Oct 25, 2019

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The Medical Information line at DAN (Divers Alert Network) occasionally receives questions regarding pacemakers and their compatibility with safe diving. Many pacemakers, in fact, will tolerate the pressures encountered in recreational SCUBA diving, but they do need to be checked with the manufacturer’s specification to assure compliance with increases in pressure. However, as is often indicated with questions regarding diving and medications, the underlying disorder or pathology is generally the primary concern for fitness to scuba dive. For example, Mobitz Type II or Second degree heart blocks are usually considered medically disqualifying, as they may predispose the individual to sudden paroxysmal dysrhythmias with the associated sudden limitation in exercise tolerance - which, according to Dr. John Parker in his text "The Sports Diving Medical", diving is contraindicated. Benign causes such as congenital heart block, treated with a pacemaker should have a cardiological assessment prior to diving. Additional concerns:

• Fixed-rate pacemakers may represent a problem to the wearer who needs to respond vigorously to an emergency situation, since they may not allow an adequate increase in heart rate to accommodate the demands for strenuous exercise; whereas sequential pacemakers generally allow a normal cardiac response to exercise.

• It is essential to check the pressure tolerance of each individual pacemaker with the manufacturer’s specification. Many pacemakers are designed to withstand pressures up to 4 ata (atmospheres absolute) or greater, but some will only withstand 2 ata pressure.

Anyone fitted with a pacemaker who is interested in scuba diving should first consult with their cardiologist. They, as well as their physician, are also welcome to contact DAN for a diving knowledgeable physician referral or more detailed information.