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Atrial fibrillation doing statics

Thread Status: Hello , There was no answer in this thread for more than 60 days.
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Nigel Hawkins

New Member
Jul 29, 2012
14
0
0
Hi all,

I thought I would share my experience with everyone as this forum helped me diagnose a serious problem. I'm new to freediving and have just recently completed 3 out of 4 days of AIDA 2*.

I was very much hooked on my first open water freedives by the feeling of free diving on wrecks with scuba divers close by and how close fish swim by!
The problems occurred whilst I was doing some walking statics which I had been doing for approximately one month, after my final static I noticed my heartbeat was very irregular and 140bpm, I felt weak, sweaty and light headed!
I had done a lot of reading on this forum, so thought I had developed an arrhythmia, which I thought would correct itself after 12 hours or so.
Not the case, I awoke the next morning with the same symptoms: weakness, dizziness, palpitations and a general feeling of being unwell.
Booked myself into A&E to be on the safe side after some very thankful advice. They soon recognised I was in atrial fibrillation!

I was admitted to the high dependancy cardio ward where they took numerous blood tests, Bp tests, ECG's and X-rays, put me on beta blockers to try to put my heart back into normal rhythm. Failing all of that, they said we will try one more drug, (flecanide) via catheter, but if it doesn't work you will have to go into theatre under general anaesthetic and have cardioversion (electric shock) to correct the rhythm!
Luckily after 10 minutes of Flecanide I watched my heart on the monitor revert to normal rhythm which was a horrible feeling! (thought I was having a heart attack) and felt relieved but anxious of what lay ahead.

Releived. I was released feeling shattered after 30hrs in the cardio ward with a hand full of outpatient tests to complete. I've had an Ultrasound scan and I'm awaiting a holter monitor which I will have to wear for 72hrs, cholestrol and fitness tests in the next two weeks.
I have spoken to a few cardiologists about this condition and they seemed absolutely astonished that I put my heart into AF doing static apnea. I am still awaiting the final outcome, so I will keep you all updated.

For the record;
I'm 39yrs old, not on medication, I'm physically fit, I have previous scuba diving experience (BSAC dive leader) and never experienced any other problems in the past.

I was hoping to do some spearfishing so fingers crossed :)

Regards

Nigel
 
Thanks for sharing Nigel - glad you are ok. There are other accounts of AF (or at least arrhythmia - what is the difference by the way?) not sure if anyone knows exactly what causes it but apnea does put stress on the heart as far as I know unfortunately.

Is your BP normal out of curiosity?

Also how did you notice your HR was 140BPM - do you always check it or did you feel unwell and then checked?

Hope you don't mind the questions - hope you recover fine and given the ok so that you can enjoy some spearfishing.
 
Hi Simos,

Dont' mind the questions at all, if anyone else has had a similar experience maybe they can give their opinion which may help others.

I'm no medical expert but this is how it was explained to me. An Arrhythmia is a generic term for any abnormal heart rhythm. Atrial fibrillation is a specific type of arrhythmia. Atrial fibrillation is an irregular, fast heart rhythm caused by chaotic electrical activity in the atria, which are the upper chambers of the heart. Paroxysmal is a term used to describe arrhythmias that come and go suddenly. Atrial fibrillation is frequently paroxysmal, but can be chronic and more sustained (i.e. always present, as opposed to coming and going). There are other examples of paroxysmal arrhythmias, so it is important to distinguish between them because the treatment and prognosis can be quite different.

Yes my blood pressure is normal and I monitor it regulary. I noticed the 140bpm immediately. To be quite honest I did push myself physically more than ever before, (maybe too much too soon had something to do with it?) I had a friend walking by me whilst I was doing the walking apnea acting as safety, I had just done a few hard sets then tried for a maximum.
As I exhaled and focused on my breathing I knew there was something wrong, I felt dizzy, clammy, palpitations and sweaty palms, as if I had just been running.
I had a pulse oximeter so immediately took a reading, my O2 sats were at 97% and heart rate was flicking between 60 and 140 every 3 seconds!
 
This might sound like a strange coincidence for a freediver, but the human dive relex slow the heart rate and it has been used to stop paroxysmal atrial tachycardia (or SVT)

THE DIVING REFLEX USED TO TREAT PAROXYSMAL ATRIAL TACHYCARDIA : The Lancet

So plunging your face into cold water might have brought your SVT under control without drugs.

Needlss to say, hopping in some cold water to freedive would be a good idea during an SVT episode :)
 
Last edited:
Interesting read there Sross.

Simos, The information on the Apnea.cz (hypoxia and cardiac arrhythmia thread) is very informative. The disturbing fact is that arrhythmias during apnea were more common in the test subjects than people think.

Very interesting read thanks...
 
I hope you will make a full recovery Nigel and return to spearfishing...
 
A few short comments:

Atrial Fibrillation has an average rhythm of 130bpm (90 - 150), and does often occur at an age above 60 -70 years. However some individuals might be susceptible at an younger age. One factor might be distention of the right atria, which might happen with high pressures in the lungs. While an static breath-hold with lung packing might be an logical explanation of an bout of atrial fibrillation, it hasn't been that often observed.

Supra ventricular rhythms, especially AVNRT, can converge to an normal rhythm when invoking the dive reflex, but this is a different kind of rhythm compared with atrial fibrillation.

Medication, especially béta-blokkade, might negatively affect your dives, because it might hamper to compensate hypoxia on longer divers. However it has not been tested what actually would happen. It is unknown how flecainide (Tambocor) would respond to freediving.

I think the heart echo is currently the most important thing, to be sure that there is no structural cause of the rhythm disorder.
 
Out of interest, isn't a "walking static" a dynamic?

Did they say that your breath holds directly caused the AF? Or, were they querying whether your breath holds exacerbated an underlying, previously unknown condition causing you to go into AF?

Glad you are ok mate and thanks for sharing :)
 
Last edited:
Rik, thanks for your input.

I suppose you're right there Dafydd regarding the dynamic. I don't think there was an underlying condition as I had some serious heart tests 20 years ago as my father died suddenly. This was a precautionary measure and I was given a full bill of health with a written report from a cardiologist so I could gain entry into the Fire Service, where I have been working the past 15 years.

Having said all that you never know what could have happened, so when all the tests are complete I will have a good chat to the consultant and update this post, then hopefully it will shine a little more light on the subject.
 
Same thing happend to me, exactly. My statics were rubbish because my heart rate was rubbish. The Atrial Fibrilation developed from being noticeable at low heart rate to permananent 24/7 and severe within a year (regardless of heart rate). I was freediving / competing throughout. The fix was a hotwire burning inside the arteries, which failed as the surgeons were unable to know whether the fix worked until the operation was over. A few months later I had a second operation with a freezing wire to burn the inside of the arteries. This worked because the surgeon could monitor the condition at the same time as freeze burning the arteries. Getting it right is an instant fix. (about 50 freezes). Unfortunately during the last freeze, the wire was very close to my Phrenic nerve and paralysed it. It left my right diaphram in an elevated position. The surgeon advised me that the complication in the new procedure had happened six times in the first twenty procedures and the fix for the paralysis would occur naturally in a matter of about six months. My diaphram got back to almost normal after three months. Ten years later it is still not fully functioning (it is still raised slightly). I was lucky because during the operation I felt pain and the operation was stopped immediatly (it took me quite a long time of feeling the pain to being alert enough to wake myself up to tell the surgeon). Had I of been under anesthetic more deeply, I may not have noticed the pain and therefore the nerve would have incurred greater exposure to the freezing. The operation is through a hole in the groin under local anesthetic with a gentle anesthetic to keep you semi awake. The nerve pain was severe, in my shoulder and lasted an hour after the operation was over.
 
That is some crazy stuff. My HR is crazy irregular during apnea when it is dropping as contractions start, but I think that is fairly normal for dive induced bradycardia. It stabilizes once it finishes the drop. Once I start to breathe again it climbs to higher than resting but I want to say the climb is fairly linear. Glad you are okay.
 
Haydn,
Sounds like a very uncomfortable experience! Was your AF an underlying condition or was it bought on due to apnea? My heart rhythm is still normal after three weeks, with only one more fitness test to complete before they give me a complete diagnosis.
Since leaving hospital I've had blood tests, which were normal, holter recorder for 72 hrs (practised a few statics whilst on holter recorder) and fitness test pending. I'm waiting for the results and conclusion of all the tests soon so I'll let you know.

Do you still freedive?
 
Hello Mr. Hawkings,

At first read, readers of your story could certainly picture a major headline warning of the dangers of freediving. But after looking again of your eventual incident with irregular heart beating it was not a consequence of freediving.
The problems occurred whilst I was doing some walking statics which I had been doing for approximately one month.... soon recognised I was in atrial fibrillation!
Did you have any experience of arterial fibrillation whilst freediving in the water?

The underwater world I believe another world entirely from land. And the results of pure apnea also different while submerged under even the slightest of pressure. It’s the MDR. The mammalian dive response (reflex) is the first to arrive while submerged. Like the Special Forces, the first to be deployed. So, like the MDR is the first deployed and it does many things. The MDR is not a singularity but a soothing connection between the heart, brain and lungs that affects our physiology that is not present when we hold our breath on land. The MDR is the freediver’s constant companion that stays with us as we freedive, ie. Hold our breath while underwater. And the more we freedive the more it can strengthen. Your brain is simply having difficulty being tricked into thinking it’s in the water that would otherwise, and very possibly, protect your system from A-fib—at least likely more so that on land. There are just so many changes that take place on many levels of mind and body because of the onset MDR including to regulate the heart and protect its flow of blood into the peripheries. I would dare to say and hypothesize that A-fib occurs less in the water than on the land.

I would also say that perhaps you were stressing your body and mind too much in the first place by being such a good and diligent new freediving student in preparing for your Aida 2* by holding your breath every day for a month with apnea walks. And you did these diligent and daily apnea walks for what reason before your course? I’d consider this to be very advanced training especially before taking a fundamental and basic starting freediving course as contained in Aida2* (or its match, SSI L1). Without knowing the exact structure of your apnea walks (your duration, tables, amount of sets, etc.) it is also impossible to know just how you affected your system without also taking into account your diet and hydration levels that could have also played a factor among many other variables such as alcohol intake during this period. Apnea walks are pretty intense forms of apnea training especially for one not even freediving yet! I don’t even do them, perhaps because I freedive every day and would much rather hold my breath in the sea.

Sure, the medical factor also plays a large role and may certainly be the final factor deciding whether you should pursue freediving further or if at all ever to hold your breath again. If it was I, I would be curious if to see if breatholding underwater with the full influence of the MDR would ever cause another onset of A-fib.

Freediving is not simply about holding your breath. Freediving is not about doing dry statics every day for a month. Freediving is about being in the water realizing a profound effect upon mind and body caused by the instant touch of atmospheric pressure.

This is really an assumed-risk sport and we do it for many reasons each different to everyone, whether it be to test our limits on a single breath, to be on the edge of fear and acceptance as we plummet down to new depths, or just to experience the thrill of being breathless under the pressure of the water for fun at shallow depths, to spearfish in the sea for food, or to experience a parallel of the process of death and rebirth as contained within each freedive.

Perhaps A-fib COULD result from any activity possible. Play some really high-stakes poker and you’ll likely to have some skipped heart beats! There doesn’t appear to be a singular trigger but more likely a culmination of variable sequences that are unknown. Doctors of course just don’t know! Causes is a good page for information.

Exactly the cause of your single case of A-fib is likely to remain unknown, but it is good to know that is was not due to freediving. Your single and isolated case of A-fib could just remain an unexplainable event.

You will likely be given a ‘clean bill of health’ where you will choose if you want to engage in underwater breath-hold diving.
I was hoping to do some spearfishing so fingers crossed :)

[FONT=&quot]It's very possible. But will you listen to your doctor if he says ,"don't you dare hold your breath under water for as long as you can!" In this case, you may have to be a hero if you want to be a spearo.:martial[/FONT]
 
Hello Mr. Hawkings,

At first read, readers of your story could certainly picture a major headline warning of the dangers of freediving. But after looking again of your eventual incident with irregular heart beating it was not a consequence of freediving.

Did you have any experience of arterial fibrillation whilst freediving in the water?

The underwater world I believe another world entirely from land. And the results of pure apnea also different while submerged under even the slightest of pressure. It’s the MDR. The mammalian dive response (reflex) is the first to arrive while submerged. Like the Special Forces, the first to be deployed. So, like the MDR is the first deployed and it does many things. The MDR is not a singularity but a soothing connection between the heart, brain and lungs that affects our physiology that is not present when we hold our breath on land. The MDR is the freediver’s constant companion that stays with us as we freedive, ie. Hold our breath while underwater. And the more we freedive the more it can strengthen. Your brain is simply having difficulty being tricked into thinking it’s in the water that would otherwise, and very possibly, protect your system from A-fib—at least likely more so that on land. There are just so many changes that take place on many levels of mind and body because of the onset MDR including to regulate the heart and protect its flow of blood into the peripheries. I would dare to say and hypothesize that A-fib occurs less in the water than on the land.

I would also say that perhaps you were stressing your body and mind too much in the first place by being such a good and diligent new freediving student in preparing for your Aida 2* by holding your breath every day for a month with apnea walks. And you did these diligent and daily apnea walks for what reason before your course? I’d consider this to be very advanced training especially before taking a fundamental and basic starting freediving course as contained in Aida2* (or its match, SSI L1). Without knowing the exact structure of your apnea walks (your duration, tables, amount of sets, etc.) it is also impossible to know just how you affected your system without also taking into account your diet and hydration levels that could have also played a factor among many other variables such as alcohol intake during this period. Apnea walks are pretty intense forms of apnea training especially for one not even freediving yet! I don’t even do them, perhaps because I freedive every day and would much rather hold my breath in the sea.

Sure, the medical factor also plays a large role and may certainly be the final factor deciding whether you should pursue freediving further or if at all ever to hold your breath again. If it was I, I would be curious if to see if breatholding underwater with the full influence of the MDR would ever cause another onset of A-fib.

Freediving is not simply about holding your breath. Freediving is not about doing dry statics every day for a month. Freediving is about being in the water realizing a profound effect upon mind and body caused by the instant touch of atmospheric pressure.

This is really an assumed-risk sport and we do it for many reasons each different to everyone, whether it be to test our limits on a single breath, to be on the edge of fear and acceptance as we plummet down to new depths, or just to experience the thrill of being breathless under the pressure of the water for fun at shallow depths, to spearfish in the sea for food, or to experience a parallel of the process of death and rebirth as contained within each freedive.

Perhaps A-fib COULD result from any activity possible. Play some really high-stakes poker and you’ll likely to have some skipped heart beats! There doesn’t appear to be a singular trigger but more likely a culmination of variable sequences that are unknown. Doctors of course just don’t know! Causes is a good page for information.

Exactly the cause of your single case of A-fib is likely to remain unknown, but it is good to know that is was not due to freediving. Your single and isolated case of A-fib could just remain an unexplainable event.

You will likely be given a ‘clean bill of health’ where you will choose if you want to engage in underwater breath-hold diving.


[FONT=&quot]It's very possible. But will you listen to your doctor if he says ,"don't you dare hold your breath under water for as long as you can!" In this case, you may have to be a hero if you want to be a spearo.:martial[/FONT]

Sorry, don't really see the point of all this as apart from guessing and some generic statements (and a link to an amateur site), there is no more information or insight.

I wouldn't have minded it at, I am certainly no expert either, apart from the fact that I detect some form of annoyance it was even suggested that AF might have been caused/triggered by freediving or related training with a generous pinch of 'I know better' sprinkled on top.

Apologies if I read your post wrong or misunderstood what you are saying, just don't think that approaching these threads that could indeed add some valuable info in this way is in any way helpful. We should be glad people take the time to share medical info related to freediving (or apnea walks if you prefer), even if it's about a negative effect.
 
I have had four Atrial Fibrillation events, two of them requiring hospitalisation, and after failing to respond to drugs, a "reboot" under anesthetic by defibrillator, and two that self corrected after a number of hours. ALL of them were associated with freediving. The first hospitalisation following a CO2 table, and the second involving a depth session (less than 20meters, but in rather trying windy and cold conditions).

The initial response from the cardiac staff at the local hospital was to advise against freediving. However, the cardiac specialist later admitted to me that when I told them I had been freediving, they looked up freediving on wikipedia, so that opinion is a tad suspect.
I was put on a course of 100mg flecainide acetate (Tambucor). In talking to a dive doctor who does know what freediving is, her recommendation was to take things very very slowly, and push my limits exceedingly gradually. This I did.
My course of Flecainide finished, and some two and a bit weeks later while diving, I had another AF incident, which in this case self corrected. (It's worth noting that flecainide takes a while to get out of the system.)
I am now on 200mg Flecainide, and back into a slow but steady work on increasing my distances etc. I am now back to, and exceeding, previous distances and tiems etc before my first AF incident.
After a year on 200mg Flecainide, I am currently in the process of reassesment and follow up, with a year free of incident. The specialist has cleared me to dive (in the broad sense including scuba), but until my GP has given me a full followup assessment, I can't get the full medical clearance to compete. I suspect that I will have to put together a co-ordinated plan to get that clearance(and that it will partly be a process of educating the local medical professionals about freediving.)

Conclusion?
My experience of the phenomena, plus my reading of the clinical and academic literature suggests the following.
1) Lots of people experience tachycardia or arythmias after long breathholds. In most people these are self correcting.
2) In some cases these arythimias fail to self correct.
3) Flecainide appears to prevent people going into arthmias.
I say this very advisedly for the following reasons.
a) I am not a medical professional, although I do have training at dealing with scientific literature.
b) The sample size for this claim is small. Clinical studies of freedivers are small, and as far as I know, the sample size of non-correcting arythmias is, well, you and me. :)
c) What's more, the combination of negative psyhological feedback loops into apnea dives is such that I doubt that I was "pushing" things as much as I was previously. The feeling of being a bit "hearty" during a breathhold was, and still is, a source of a stress, and stress is one sure way of gettign someone to pull out of a dive well before their limit is reached.

Final conclusion? Freediving probably exacerbates a underlying condition. Like anything else to do with safety, it needs monitoring, and sensible management.
 
Thanks for sharing - interestingly it seems like sleep apnea is always quoted as one of the causes for AF.

Now obviously sleep apnea and freediving are very different in many ways but also some effects should be the same - do you think that it's reasonable to assume that if sleep apnea can cause AF, breatholding exercises where one voluntarily holds their breath also probably can? ie should we look more closely to the conclusions of the sleep apnea/AF studies, where the sample size will be bigger?
 
Not sure about whether sleep apnea is relevant, and I suspect only a deep understanding of sleep apnea and voluntary apnea would provide that information. For what its worth, my understanding is that sleep apnea involves repeated short apnea events that disrupt regular sleep patterns and does not involve prolonged apnea of the sort freedivers are engaged in.
 
Hi Spearo_The_Hero,

This post is not meant to be negative in anyway at all, most people getting into this sport will never encounter any problems. However, I have been putting my body under varying amounts of physical stress since the age of 16 when I first joined the army (infantry), I have been scuba diving since the age of 15, swam for my local swimming club and have been a fireman for the past 15 years. I train hard in the gym four times a week and have done since leaving school 23 years ago. I'm 5ft 11, weigh 13 stone, don't drink much alcohol or smoke, maintain a very active & healthy lifestyle and regularly walk up 3500ft mountains.

I've never had any problems at all in the past and have regular medicals due to my job (including physical lung volume & cardio tests).
My episode of atrial fibrillation was definitely bought about by an apnea walk, which I wouldn't have been doing if I wasn't apnea training. There are various O2 & C02 tables which are common knowledge training aids. Maybe I do have an underlying condition? Maybe I pushed myself too far in a short amount of time? But maybe this would have reared it's head by running 3500ft with a back pack on three weeks previous? Who knows?

What I have found out since this AF incident has made me realise that apnea puts a whole lot more stress on the heart plus increased risk of stroke/cardiac problems due to increased red blood cell levels than what was generally made available.
 
Thanks also for sharing sapienaustralis,

This post is very informative. Interesting to hear your have exceeded previous distances.
Good luck in your follow up assessment...
 
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