Should I insist on getting a pacemaker?

Don't sell your dive gear

by El Gordo - 2019-01-20 09:29:05

I have bradycardia and a 3rd degree heart block, and had a pacemaker installed in June. My cardiologist says I can do whatever I did before, except jackhammer or arc weld. My pacemaker is rated to 4 atm, which gives me 100 feet to play in, and our yearly dive trip to Roatan is in February.

You sound like I did before my PM, the same symptoms. I can't tell you to dive or not, but if you aren't passing out, I don't see why not. If you are or have passed out, I'd wait until this gets straightened out (if you lose consciousness, your jaw muscles relax and the reg can fall out of your mouth). 

If you have this type of issue with your heart, you should try Nitrox. I dove with it last year, and the added O2 made a huge difference; I felt better after I dove than before I went in. Now that my heart is working properly, I don't expect the same results this year, but I'll still use it.

Even if you don't dive right now, keep your stuff. It'll cost a lot to replace when everything's fixed and you want to get back into the water.

I suspect your cardiologist isn't a diver.

Get a second opinion from an EP

by wxbuoy - 2019-01-20 10:10:23

Please get a second opinion. Like others have stated interventional cardiologists tend to go down the same street of thought in their diagnosis/treatment routines. I had the same issues as you have. I also had paroxysmal Afib. I was still borderline, so my cardiologist implanted a loop recorder. Minor procedure that puts something the size of a small skinny thumb drive under the skin. Other than the 1/2" incision, no one would know it was there. Just like a halter monitor, I could "alert" when I experienced symptoms. My Dr. would get daily reports and we would go over what it was showing when I went in for my visits. Also, if I experienced a "bad episode" I could call the office and they would do a live pull of the data or if I went to the ER for issues, they could look at the data as well as to what caused me to come in.

I had the loop recorder for 14 months before it finally showed that I needed a pacemaker. Good hard data. Not his guess of what was happening, or my fear of what was happening, but a years’ worth of ECG’s during episodes (most of which, I didn’t know where happening!)

I also wear an apple watch and took in my cardiogram print outs (pulse rates) as well to discuss my resting rates and fluctuations.

The important thing is to have a cardiologist you can talk to who will take the time to explain things and work with you.

decisions, decisions

by Tracey_E - 2019-01-22 21:45:34

You are borderline in that you are not in immediate danger without it so the question becomes will you feel better and have a better quality of life with it? I'm no doctor but my guess is an emphatic yes. Why give up sports you love when you could do them if you were paced? IMO, getting a pacer is a small price to pay to feel better and continue doing what you love. Like El Gordo's, my pacer is rated to 4 atm. 

I have a different condition than yours, congenital av block, but I knew for years I would be paced eventually. My doctor wanted to wait until I needed it because I was so young. I was afraid of it and happy to procrastinate. They day I got it, my rate tanked to 22 and I ended up in emergency surgery, which is not the easy way to do it. After, it was like night and day and I felt sooooo much better. Did I need it sooner? Who knows. Would I have felt a lot better if I'd gotten it sooner? Yep. In hindsight I wish I'd gotten it as soon as I started getting more tired, as soon as I started having daily dizzy spells, as soon as there were things I wanted to do that I could not. I wish I hadn't waited and I'm a little resentful that the doctor encouraged it, that he never told me that it would make such a difference in my quality of life. I was 27 when I got the first one. I'm 52 now, still going strong, healthy and active, have never had a serious complication, have never once regretted anything but waiting so long to get that first one. Don't rush into it, but if you are symptomatic, don't be afraid of it. 

Update:

by Azuma - 2019-01-30 00:34:26

I had another conversation with the EP.

She shared, the technical data provided to doctors by Medtronic states that Medtronic pacemakers may be pressurised up to 15metres / 49feet depth. Any depth further may result in permanent damage to the pacemaker unit. Hence, deep sea diving is not allowed. Only snorkeling is approved. 

diving

by Tracey_E - 2019-02-01 12:26:40

Is there a reason your doctor is only considering Medtronic? Since you don't have one yet, ask about St Judes/Abbot. I know my SJM is rated to 4atm which is about 100 ft in saltwater so I am allowed to dive. There is a lot fun stuff to be seen between deep sea diving and snorkeling.