Frequently Asked Questions on Diving Medicine

[vc_row css_animation=”” row_type=”row” use_row_as_full_screen_section=”no” type=”full_width” angled_section=”no” text_align=”left” background_image_as_pattern=”without_pattern”][vc_column el_class=”page-text”][vc_column_text]These implantable devices have been found to benefit patients at high risk of ventricular tachycardia, ventricular fibrillation, or other rhythm defects that can lead to sudden cardiac arrest. The pacemaker will increase the heart rate of the patient if it slows to an inefficient rate. With or without the pacemaker feature, these internal devices are used to treat potentially life-threatening rhythms. It is the opinion of diving medicine professionals that due to this potential life threat, individuals with these implanted devices are disqualified from diving. These devices are intended to prevent sudden cardiac arrest, but the heart itself may be in generally poor health which is not compatible with safe diving. As relaxing as diving is there is still an increased work-load placed on the heart. The heart needs to be able to respond effectively to any increased exercise demand, especially in an emergency situation. A heart that is prone to life-threatening rhythms has most likely sustained injury from coronary artery disease or other conditions that affect the muscle tissue of the heart, or its electrical pathways. Any exercise restrictions from the diver’s cardiologist would be a good indicator that diving would hardly be in their best interest.

Implantable devices can be both defibrillators and pacemakers, or even have both functions in the same device, depending on the underlying pathology.

In the first case, the indications for implantation are all those pathologies with a high risk of life-threatening tachyarrhythmias: ischaemic heart disease (post-infarction) associated with severe ventricular dysfunction and cardiomyopathies (dilated, hypertrophic and congenital arrhythmogenic heart diseases).

In the second case, the most common indications are atrioventricular block, sinus node disease, neuromediated syncope and atrial fibrillation.

In general, the pathology that necessitated the implantation of the device will determine the subsequent “fit to dive” question, which must be carefully assessed by the arrhythmology specialist in consultation with the diving physician.

In addition, if there are no cardiological contraindications to returning to diving, it is essential to choose a device that is compatible with hyperbaric conditions, for which the specialist must consult the company that certifies the safety of this type of device at depth. [/vc_column_text][/vc_column][/vc_row]

[vc_row css_animation=”” row_type=”row” use_row_as_full_screen_section=”no” type=”full_width” angled_section=”no” text_align=”left” background_image_as_pattern=”without_pattern”][vc_column el_class=”page-text”][vc_column_text]Se ha descubierto que estos dispositivos implantables benefician a pacientes con alto riesgo de taquicardia ventricular, fibrilación ventricular u otros trastornos del ritmo cardíaco que pueden provocar un paro cardíaco repentino. El marcapasos aumentará la frecuencia cardíaca del paciente si esta se ralentiza hasta alcanzar un ritmo ineficaz. Con o sin la función de marcapasos, estos dispositivos internos se utilizan para tratar ritmos cardíacos potencialmente mortales. Los profesionales de la medicina del buceo opinan que, debido a este riesgo potencial para la vida, las personas con estos dispositivos implantados no pueden bucear. Estos dispositivos están diseñados para prevenir el paro cardíaco repentino, pero el corazón en sí mismo puede estar en mal estado de salud, lo que no es compatible con la práctica segura del buceo. Por muy relajante que sea el buceo, sigue suponiendo un aumento de la carga de trabajo para el corazón. El corazón debe ser capaz de responder eficazmente a cualquier aumento de la demanda de ejercicio, especialmente en una situación de emergencia. Un corazón propenso a ritmos cardíacos potencialmente mortales probablemente haya sufrido lesiones por una enfermedad coronaria u otras afecciones que afectan al tejido muscular del corazón o a sus vías eléctricas. Cualquier restricción al ejercicio impuesta por el cardiólogo del buceador sería un buen indicador de que el buceo no sería recomendable.

Los dispositivos implantables pueden ser desfibriladores y marcapasos, o incluso tener ambas funciones en el mismo dispositivo, dependiendo de la patología subyacente.
En el primer caso, las indicaciones para la implantación son todas aquellas patologías con alto riesgo de taquiarritmias potencialmente mortales: cardiopatía isquémica (postinfarto) asociada a disfunción ventricular grave y miocardiopatías (dilatadas, hipertróficas y arritmogénicas congénitas).
En el segundo caso, las indicaciones más frecuentes son el bloqueo auriculoventricular, la enfermedad del nódulo sinusal, el síncope neuromediado y la fibrilación auricular.
En general, la patología que ha motivado la implantación del dispositivo determinará la posterior «aptitud para bucear», que deberá ser evaluada cuidadosamente por el especialista en arritmología en consulta con el médico especialista en buceo.
Además, si no existen contraindicaciones cardiológicas para volver a bucear, es imprescindible elegir un dispositivo compatible con las condiciones hiperbáricas, para lo cual el especialista deberá consultar a la empresa que certifica la seguridad de este tipo de dispositivos en profundidad.[/vc_column_text][/vc_column][/vc_row]

[vc_row css_animation=”” row_type=”row” use_row_as_full_screen_section=”no” type=”full_width” angled_section=”no” text_align=”left” background_image_as_pattern=”without_pattern”][vc_column el_class=”page-text”][vc_column_text]These implantable devices have been found to benefit patients at high risk of ventricular tachycardia, ventricular fibrillation, or other rhythm defects that can lead to sudden cardiac arrest. The pacemaker will increase the heart rate of the patient if it slows to an inefficient rate. With or without the pacemaker feature, these internal devices are used to treat potentially life-threatening rhythms. It is the opinion of diving medicine professionals that due to this potential life threat, individuals with these implanted devices are disqualified from diving. These devices are intended to prevent sudden cardiac arrest, but the heart itself may be in generally poor health which is not compatible with safe diving. As relaxing as diving is there is still an increased work-load placed on the heart. The heart needs to be able to respond effectively to any increased exercise demand, especially in an emergency situation. A heart that is prone to life-threatening rhythms has most likely sustained injury from coronary artery disease or other conditions that affect the muscle tissue of the heart, or its electrical pathways. Any exercise restrictions from the diver’s cardiologist would be a good indicator that diving would hardly be in their best interest.

Implantable devices can be both defibrillators and pacemakers, or even have both functions in the same device, depending on the underlying pathology.

In the first case, the indications for implantation are all those pathologies with a high risk of life-threatening tachyarrhythmias: ischaemic heart disease (post-infarction) associated with severe ventricular dysfunction and cardiomyopathies (dilated, hypertrophic and congenital arrhythmogenic heart diseases).

In the second case, the most common indications are atrioventricular block, sinus node disease, neuromediated syncope and atrial fibrillation.

In general, the pathology that necessitated the implantation of the device will determine the subsequent “fit to dive” question, which must be carefully assessed by the arrhythmology specialist in consultation with the diving physician.

In addition, if there are no cardiological contraindications to returning to diving, it is essential to choose a device that is compatible with hyperbaric conditions, for which the specialist must consult the company that certifies the safety of this type of device at depth. [/vc_column_text][/vc_column][/vc_row]

[vc_row css_animation=”” row_type=”row” use_row_as_full_screen_section=”no” type=”full_width” angled_section=”no” text_align=”left” background_image_as_pattern=”without_pattern”][vc_column el_class=”page-text”][vc_column_text]These implantable devices have been found to benefit patients at high risk of ventricular tachycardia, ventricular fibrillation, or other rhythm defects that can lead to sudden cardiac arrest. The pacemaker will increase the heart rate of the patient if it slows to an inefficient rate. With or without the pacemaker feature, these internal devices are used to treat potentially life-threatening rhythms. It is the opinion of diving medicine professionals that due to this potential life threat, individuals with these implanted devices are disqualified from diving. These devices are intended to prevent sudden cardiac arrest, but the heart itself may be in generally poor health which is not compatible with safe diving. As relaxing as diving is there is still an increased work-load placed on the heart. The heart needs to be able to respond effectively to any increased exercise demand, especially in an emergency situation. A heart that is prone to life-threatening rhythms has most likely sustained injury from coronary artery disease or other conditions that affect the muscle tissue of the heart, or its electrical pathways. Any exercise restrictions from the diver’s cardiologist would be a good indicator that diving would hardly be in their best interest.

Implantable devices can be both defibrillators and pacemakers, or even have both functions in the same device, depending on the underlying pathology.

In the first case, the indications for implantation are all those pathologies with a high risk of life-threatening tachyarrhythmias: ischaemic heart disease (post-infarction) associated with severe ventricular dysfunction and cardiomyopathies (dilated, hypertrophic and congenital arrhythmogenic heart diseases).

In the second case, the most common indications are atrioventricular block, sinus node disease, neuromediated syncope and atrial fibrillation.

In general, the pathology that necessitated the implantation of the device will determine the subsequent “fit to dive” question, which must be carefully assessed by the arrhythmology specialist in consultation with the diving physician.

In addition, if there are no cardiological contraindications to returning to diving, it is essential to choose a device that is compatible with hyperbaric conditions, for which the specialist must consult the company that certifies the safety of this type of device at depth. [/vc_column_text][/vc_column][/vc_row]

[vc_row css_animation=”” row_type=”row” use_row_as_full_screen_section=”no” type=”full_width” angled_section=”no” text_align=”left” background_image_as_pattern=”without_pattern”][vc_column el_class=”page-text”][vc_column_text]Diese implantierbaren Geräte haben sich als vorteilhaft für Patienten mit einem hohen Risiko für ventrikuläre Tachykardie, Kammerflimmern oder andere Herzrhythmusstörungen erwiesen, die zu einem plötzlichen Herzstillstand führen können. Der Herzschrittmacher erhöht die Herzfrequenz des Patienten, wenn diese auf eine ineffiziente Frequenz absinkt. Mit oder ohne Schrittmacherfunktion werden diese internen Geräte zur Behandlung potenziell lebensbedrohlicher Herzrhythmen eingesetzt. Tauchmediziner sind der Meinung, dass Personen mit diesen implantierten Geräten aufgrund dieser potenziellen Lebensgefahr vom Tauchen ausgeschlossen werden sollten. Diese Geräte sollen einen plötzlichen Herzstillstand verhindern, aber das Herz selbst kann sich in einem allgemein schlechten Gesundheitszustand befinden, der mit sicherem Tauchen nicht vereinbar ist. So entspannend das Tauchen auch ist, es stellt dennoch eine erhöhte Arbeitsbelastung für das Herz dar. Das Herz muss in der Lage sein, effektiv auf jede erhöhte Trainingsanforderung zu reagieren, insbesondere in einer Notfallsituation. Ein Herz, das zu lebensbedrohlichen Rhythmen neigt, hat höchstwahrscheinlich eine Verletzung durch eine koronare Herzkrankheit oder andere Erkrankungen erlitten, die das Muskelgewebe des Herzens oder seine elektrischen Bahnen beeinträchtigen. Jegliche Einschränkungen des Kardiologen des Tauchers in Bezug auf körperliche Betätigung sind ein guter Indikator dafür, dass Tauchen kaum in seinem besten Interesse wäre.

Implantierbare Geräte können sowohl Defibrillatoren als auch Herzschrittmacher sein oder sogar beide Funktionen in einem Gerät vereinen, je nach zugrunde liegender Pathologie.

Im ersten Fall sind die Indikationen für eine Implantation alle Erkrankungen mit einem hohen Risiko für lebensbedrohliche Tachyarrhythmien: ischämische Herzkrankheit (nach einem Infarkt) in Verbindung mit schwerer ventrikulärer Dysfunktion und Kardiomyopathien (dilatative, hypertrophe und angeborene arrhythmogene Herzkrankheiten).

Im zweiten Fall sind die häufigsten Indikationen atrioventrikuläre Blockade, Sinusknotenerkrankung, neuromediierte Synkope und Vorhofflimmern.

Im Allgemeinen bestimmt die Pathologie, die die Implantation des Geräts erforderlich machte, die anschließende Frage der „Tauchfähigkeit“, die vom Arrhythmiespezialisten in Absprache mit dem Tauchmediziner sorgfältig beurteilt werden muss.

Wenn keine kardiologischen Gegenanzeigen für die Wiederaufnahme des Tauchens vorliegen, ist es außerdem wichtig, ein Gerät zu wählen, das mit hyperbaren Bedingungen kompatibel ist. Hierzu muss der Spezialist das Unternehmen konsultieren, das die Sicherheit dieses Gerätetyps in der Tiefe zertifiziert.[/vc_column_text][/vc_column][/vc_row]