Baylor University Medical Center Proceedings April 2017 - 236

Figure 2. Skydiving performance and outcome: (a) belly-fly maneuver at iFLY Dallas; (b) free-fall drop test, designed to simulate the force of the chute-pack harness
on the torso; (c) true jump at Dallas Skydive Center.

walked to the nearby ﬁtness center where he put on his chutepack harness. Two sets of 5 carabineers were linked together
and attached to handles on an 8-foot squat rack platform. The
bottom carabineers on each side were attached to each side of
the top of the patient's chute-pack harness. The patient was
asked to hold the handles on the squat rack while two CR staﬀ
members pushed his legs and body horizontally until he was
parallel to the ﬂoor. The patient was asked to release the handles
while the CR staﬀ simultaneously let go of his legs. Before
being stopped by the carabineers, this maneuver resulted in a
0.35 second free-fall drop at a speed of 11.3 feet per second and
was repeated ﬁve consecutive times. Immediately following the
test, the patient returned to CR, where the electrophysiology
nurse specialist performed a device interrogation and conﬁrmed
that no change in lead status had occurred during the simulated
free-fall drop test.
The patient was released to perform one true jump at the
Dallas Skydive Center (Figure 2c). He subsequently traveled to
Arizona 10 days later for a skydiving competition, during which
he successfully jumped 35 times. He then returned to the Baylor
CR facility where a ﬁnal device interrogation was performed.
One arrhythmia was noted: a single 6-beat run of nonsustained
supraventricular tachycardia that was deemed clinically insigniﬁcant by the supervising electrophysiology nurse specialist.
No change in lead status had occurred during the jumps.

implementation may be precluded from skydiving due to the risk
of arrhythmias and the potential for pacemaker lead displacement. On the simulated free-fall drop test, the patient endured
ﬁve consecutive free-fall stop forces, calculated to be 175% of
the "g" force one endures during an actual parachute jump. From
device interrogation reports obtained over the course of the CR
program, no recurrent sustained arrhythmias or lead displacement had occurred. Approximately 17 months after completion
of CR, the patient had performed 800 true skydiving jumps
without any adverse events, symptoms, or lead displacement.
Acknowledgments
Grant support was provided by an anonymous foundation,
the Harry S. Moss Heart Trust, and the Baylor Health Care
System Foundation, Dallas, Texas, through the Cardiovascular
Research Review Committee and in cooperation with the Baylor
Heart and Vascular Institute. The authors thank the Cardiovascular Research Review Committee for their continued support
of cardiovascular rehabilitation research projects. We thank the
Biotronik manufacturer's clinical specialist, Gary Johnson, for
his assistance; iFLY Dallas and Dallas Skydive Center for permitting the patient to perform skydiving jumps at their facility; and
Martha Bradshaw, RN, PhD, who helped develop and prepare
the manuscript.
1.

DISCUSSION
The sport of skydiving requires specific cardiovascular
endurance and muscular strength. A skydiver "free falls" after he
leaves the aircraft, reaching speeds of 100 miles per hour in about
15 seconds. After the lines are pulled and the parachute opens,
the force on the skydiver is approximately 4 times the force
of gravity (4 "g's") (3). Patients who have endured pacemaker

236

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