There are often many questions surrounding heart problems and scuba diving. One of the most pressing issues is that of an irregular heartbeat and one of the increasingly common types of irregular heartbeats is called atrial fibrillation. Atrial fibrillation is a condition in which the upper two chambers of the heart, known as the atria, begin to beat very rapidly and irregularly. It can increase to as high as 600 beats per minute. However, the bottom two chambers of the heart, the ventricles, are not fully affected by the beating of the atria and end up beating at about 1/5 to 1/4 as many beats per minute. This condition is not limited to non-divers as some divers may develop this issue during the course of their life. So, can individuals who experience atrial fibrillation enjoy the underwater world safely?
Those with atrial fibrillation often experience a drop in blood pressure and may feel fatigued, light headed, and/or short of breath. If the person also suffers from coronary heart disease, then he or she may also have chest pain. All of these symptoms interfere with a person's ability to exercise which means that divers who choose to dive with this condition place themselves at high risk as any of the symptoms could cause an underwater emergency and possible death.
Atrial fibrillation is sometimes caused by an abnormality of the heart, but it can also be caused by adrenaline-like medications that overstimulate the heart, too much alcohol, an overactive thyroid, or too much of the hormone acetylcholine; which stimulates the atrium and slows the heart rate. Anyone who has high blood pressure, coronary heart disease, or abnormalities of the heart valves or the heart muscle can also suffer from atrial fibrillation. When it comes to alcohol, the affect it can have on the heart can be summed up by the nickname for atrial fibrillation, which is the “Holiday Heart Syndrome.” Caffeine is also suspected to cause atrial fibrillation.
So, how is atrial fibrillation treated and can someone who has it dive? Well, the main concern with atrial fibrillation is the possibility that blood clots will form in the atria of the heart due to the irregular heartbeat. If this happens, then there is a high risk of a stroke occurring. There is medication available that will prevent atrial fibrillation and divers who are prone to the condition should take the necessary medication. In fact, diving can actually bring on atrial fibrillation in individuals who experience it because of the redistribution of a large volume of blood from the legs to the upper body, which increases the pressure inside the walls of the atria.
In general, divers can still dive if they suffer from atrial fibrillation, as long as the condition is properly managed. For those who have a “mild” case, taking medication to keep the heart rate down before the dive may be all that is required. For those who experience a constant irregular heartbeat, they must keep it under control with medication and they also must take an anticoagulant to ensure that blood clots do not form. However, if atrial fibrillation exists because of an underlying heart condition, then that heart condition must be assessed before a diver will be given the green light to take the plunge. Heart disease can cause serious problems when diving and can even cause death. For those divers taking an anticoagulant, caution must be exercised as bleeding can cause increased blood loss. It is crucial that divers taking an anticoagulant avoid sinus and ear squeezes at all costs because sinus or ear squeezes can cause bleeding in these areas of the body, which can lead to infection.
Fortunately, most divers who suffer from the condition of atrial fibrillation can still enjoy recreational diving as long as the proper medications are being taken and the heart rate and irregular heartbeat are properly managed. Caution should still be used in these situations due to the risk of taking anticoagulants while diving. It is also important that any diver with atrial fibrillation consult with their physician and have their heart tested to ensure that it can handle the stress of exercise. Once you have your condition under control and you have the green light from your doctor, you will be able to enjoy the wonders that await you beneath the waves and know that you will be safe while doing so.