Swimming With A Pacemaker: A Potential Danger
As has been the theme of the past few articles, pacemakers are designed to maintain one’s life, but they are far from perfect devices. While modern pacemakers are generally sturdy enough to withstand most common outdoor activities, this does not mean that all are always perfectly safe in every circumstance. Hiking was discussed in the previous article, and now we will move on to swimming. Given this time of year, is it worth putting on a swimsuit, slathering on sunscreen, and jumping into a pool or taking a dip in the ocean?
Let’s find out.
Swimming is considered an ideal activity for maintaining one’s general health. The article, Swimming Exercise: Impact of Aquatic Exercise on Cardiovascular Health by Hirofumi Takana states that, “swimming is an exercise modality that is highly suitable for health promotion and disease prevention, and is one of the most popular, most practiced and most recommended forms of physical activity” (Tanaka, 2009). Another article, Why Swimming Might Be The Best Form of Exercise There Is by Dave Brummert, discusses how “when you swim on a regular basis, you’re doing your body all kinds of favors: you’re exercising in a variety of ways and you’re doing all of them at the same time” (Brummert, 2020). This can provide all-around health benefits, “as with any form of cardiovascular exercise, you reap significant benefits to your long-term health by swimming regularly. It can make your heart work more efficiently by making it stronger. A stronger heart pumps blood more efficiently, meaning you’ll gain improved circulation throughout your body (even your brain!). And because our blood is how we receive nutrients to our bodies, swimming helps improve circulation and cardiac efficiency, reducing your risk of cardiovascular disease” (Brummert, 2020). Therefore, this activity enhances cardiovascular health, in addition to and in correlation with one’s overall health. “This means you improve your cardiovascular endurance while also building muscular strength (especially in the shoulders, back, and core). You are increasing your overall coordination and strengthening the muscles you use to breathe. And because you are supporting almost none of your body weight while in the water, your joints are less stressed than they would be on solid ground running or cycling” (Brummert, 2020). Therefore, swimming is not only beneficial for maintaining and enhancing one's cardiovascular system, but also for one’s overall functioning. However, does having a pacemaker impact whether an individual can participate in this outdoor summer activity?
While pacemakers are meant to prolong and maintain your life, like with hiking, there are a few factors that should be considered. The most dangerous time for exercise is immediately after the device is implanted. This includes swimming. The article, Pacemaker Placement: What to Expect at Home, cautions that, “your chest may be sore where the doctor made the cut. You also may have a bruise and mild swelling. These symptoms usually get better in 1 to 2 weeks” (Alberta.ca, 2019). This is the initial healing stretch when it is most likely for the device to shift as it heals within the pocket of muscle. However, the healing process may take longer than that. “You may feel a hard ridge along the incision. This usually gets softer in the months after surgery. You may be able to see or feel the outline of the pacemaker under your skin” (Alberta.ca, 2019). This can potentially lead to insecurity when wearing bathing suits and engaging in swimming activities.
Personally, I only had my pacemaker placed below my diaphragm when I was two, and the two other times, in the pocket of muscle below my shoulder. This hid the device from view, which, given I was a teen and in my early thirties, allowed me to feel more secure and avoid the visibility of the device protruding beneath my skin. However, this method of insertion made the recovery process longer and more difficult, so many opt for the more straightforward procedure of having the device slipped into a muscle pocket made beneath their collarbone. However, this makes the presence of the pacemaker more noticeable and sometimes causes the patient to lose confidence in their appearance.
However, apart from this initial recovery process and the potential oddity of its shape beneath the skin, other concepts must be addressed before entering the pool if someone has a pacemaker. The first consideration is that the doctor should be consulted, as the health of the heart itself may be more of a concern for swimming than the pacemaker itself. Therefore, it is wise, in this instance, to check with a medical professional if one’s health is poor. Therefore, to remain on the safe side, before the summer season starts or at least before entering the pool, it might be a good idea to get the green light from one's cardiologist as a means of ensuring all their medical bases are covered before stepping into the water.
Strange as it may seem, there is a particular danger a swimming pool potentially poses to a pacemaker that must be considered. According to the article, Swimming Pools Causing Electromagnetic Interference on Cardiac Devices: A Case Series, this can cause EMI, or electromagnetic interference, which impacts the functioning of the pacemaker itself, and therefore can impede the individual’s health, albeit temporarily. This is because “electromagnetic interference (EMI) is the presence of extracardiac signals from the nearby environment that may be detected by a device and result in inappropriate therapy changes” (Conte, Kisling, and Needleman, 2024). For a patient swimming in a pool, this could be particularly dangerous because “pools may be a significant source of EMI. If the electrical components of a pool such as filters or underwater lights are not appropriately grounded or insulated, the accumulated energy in the water may lead to noise and subsequent device malfunction. This may be life-threatening for people who are dependent on their devices, as altered therapy may cause syncope and drowning” (Conte, Kisling, and Needleman, 2024). There have been at least “2 cases of EMI from swimming pools that resulted in inappropriate and potentially harmful alterations in device activity” (Conte, Kisling, and Needleman, 2024). This potential for EMI is rare, but present, and pacemaker patients should be aware of it before jumping in the water
While swimming is generally a healthy activity, particularly for people with heart disease, a few extra factors must be considered and addressed with one’s doctor before participating, especially in instances involving a pacemaker. However, if you are concerned about the scars or the visibility of a pacemaker device under the skin, wear it with pride during this summer activity. It is a mark of what sustains you, not what broke you.
Do you have a pacemaker? Do you enjoy swimming?
Reference List
Alberta.ca. (2019). Pacemaker Placement: What to Expect at Home. [online] Available at: https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ud2553.
Brummert, D. (2020). Why Swimming Might Be the Best Form of Exercise There Is. [online] www.orlandohealth.com. Available at: https://www.orlandohealth.com/content-hub/why-swimming-might-be-the-best-form-of-exercise-there-is.
Conte, L.M., Kisling, A.J. and Needleman, M. (2024). Swimming Pools Causing Electromagnetic Interference on Cardiac Devices: A Case Series. Annals of Internal Medicine Clinical Cases, 3(6). doi:https://doi.org/10.7326/aimcc.2024.0072.
Tanaka, H. (2009). Swimming Exercise. Sports Medicine, [online] 39(5), pp.377–387. doi:https://doi.org/10.2165/00007256-200939050-00004.
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