In brief, there are five key questions to discuss with your physician:
1. Is there any additional structural heart disease or any "holes" in the heart? And make sure you have a pacemaker not a BIV (biventricular pacer) or AICD (automated internal cardioversion defibrillator).
2. Is your specific pacemaker rated to function at 130 feet?
3. Is your cardiovascular fitness adequate (13 mets or greater) for the stress of not only diving but handling any emergency situations?
4. Are you on a blood thinner?
5. What is your underlying heart function, and is there any significant muscle damage to your heart?
Keep in mind a significant number of fatalities in recreational diving are attributable to heart conditions. However, properly screened patients with pacemakers can successfully enjoy diving after being cleared by their personal physician.