Hello everyone! I am seeking advice/opinions to help me make an informed decision about a holiday to the USA to visit my son.
On 29th March I suffered my first (totally out of the blue) episode of AF (tho not firmly diagnosed, on letter to GP said fibrillation/flutter). I had to call myself an ambulance, was all alone and pretty scared. My arms/hands were buzzing then numb, my feet too. Even my mouth, and breathing was very difficult for a short time. My blood pressure was 220/120 when I got to hospital, pulse varied from 35 to 190 for a period of about 30 minutes. My heart actually sorted itself out tho I felt lousy for the rest of the day. I was hooked up to various monitors for about 6 hours altogether, then sent home with Bisoprolol. Originally they were going to give me 5mg once a day, but as my heart rate is usually very slow they opted for 2.5mg. They said at the time that the most likely cause is high blood pressure, which is not something I have ever suffered with before, but my Dad did at a similar age to what I am now. At doctors last Monday my BP was 160/90. (that was after 3 doses of Biso). Have a 24hr BP monitor to collect tomorrow. Have appointments at hosp next week 14th April and 15th April, for a 24hr ECG and an echocardiogram. (the outside the chest one).
I am a normally fit and active 58 year old woman, I horse ride, muck out most days, and play badminton, walk the dogs etc etc. Have tried to pretty much carry on as usual- have had 3 further incidences of AF but nowhere near as severe as the first (all 3 when laying down in bed which may or may not be significant?)
I am booked to fly on May 1st to see my son in the USA, specifically Denver and the Rockies (ie at.altitude). I am assuming that I won't have my test results back by then. I will obviously ask the doctor's advice re the holiday but wonder what you lot all think? After all you are probably the experts at actually living with this condition!
I desperately want to go, have been saving for ages. Will obviously have to let the insurance company know. Am I likely to be at more risk from DVT from flying? I know there are lots of unknowns, and everyone is different, but if any of you have the time to offer your opinions I would like to know what you think.
Thanks,
Angie
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angiek
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Hi I can't tell you anything about altitude. I live at sea leval. As far as flying, it would be safe if you are on an anticoagulant. My MD (USA) told me even though I was in A Fib, as long as I was on Warfarin it was safer for me to fly now than when I was not in A fib and on Warfarin. He told me to get up and move around every 1-2 hrs and it would be fine to fly.
Several of you have mentioned Warfarin, so I will follow this up when next I see my GP. I always do walk around and wear the stockings on long haul flights too.
Hi Angie, from what you describe of your age, BP etc you must be on warfarin or similar anticoagulant. NOT aspirin.. The biggest risk from AF is stroke as you are five times more at risk than non AF people and never mind the DVT that is what would worry me. Having said that, provided that you are then there should be no worry about air travel.I know people who fly all over the world and never worry. Unless you are planning on climbing mountains the altitude thing does matter much as the aircraft are all pressurised to a reasonable level. Just make sure you stay well hydrated and off the alcohol during the flight would be my advice. BUT do discuss with your doctor and don't get fobbed off with aspirin.
Hi Bob you have me worried now as I refused warfarin ( know few people on it and always dreaded having to use it one day ) doctor accepted this and have stayed on aspirin only ,I do have PAF so not in permanent AF according to doc ! I just feel very conscious of my heartbeat all the time and have bouts of fatigue , wish you well
If you have high blood pressure which you do and have AF you already have a score of 1 on the
Chads2 system let alone Chads2Vasc2. (look them up on the main website) Being female adds a score and your age is getting close to another so I would say go warfarin whatever.. It really isn't as much of a worry as you think.
One thing nobody has mentioned yet is travel insurance. . You must tell them about your AF and there is a risk that since you are still undergoing tests they may refuse to cover you. Sorry to be a damp squib here but that is your first priority in my view. Whether you take risks with your health is a personal thing but getting stuck in another country with no medical cover is BAD idea.
By the way just having AF is the risk not how frequently you have it.
I flew last year for my son's graduation from Switzerland to Victoria BC Canada! Hell of a trip in full blown rapid AF, but I had meds with me that I knew would kick in and I was told I had 48h before needing to be cardioconverted if something didn't work out. I got on the plane, made his graduation, and am thrilled I went. It is a personal choice, it isn't a question of brave or fearful, just do you trust you can handle it. I felt any ER could handle the situation as well as another.... hope you find answers. Ask your doctor! He'll probably discuss anticoagulants. all the best -
Thankyou. Like you I have now come to the conclusion that if I needed it an ER in USA would be as well equipped as at home- but having only just experienced AF there are so many things I do not know, and it is hugely helpful to have found this forum, and use others experience to help inform my decision!
Thank you for your replies, is it likely that with the ECG and echo on 14th and 15th, I will have results in time to be started on an anticoagulant before my travel date? (if it is deemed necessary? (NHS hosp)) And would results normally go to my GP, or would I have a follow up trip at hospital?
the ECG may not show anything so you might have the decision made on the episodes you describe- did they do an ECg when you had the trip to hospital?
You mention your AF starts when you are lying down- it may be you have vagal AF which tends to start at night- if you do, be aware that beta blockers and digoxin can make this worse so other medication may be preferable
Yes they did an ECG at the hospital. The one I am having next week is a 24hr one. And yes the 3 mini episodes have all been when laying down. The first big one wasn;t though. I guess till those tests are all done I won't be able to make any decisions about my trip, but I really don't want to cancel!
Sounds like a great trip Hiking around Denver can definitely cause problems because of the altitude whether you have AF or not. Take it easy, take time to adjust. Everyone expects to be short of breath if you climb Pike's Peak! And long distance flights can raise your risk of DVT for sure. I would advise asking for an Rx for anti embolism stockings, walking every hour or so during the flight, not sitting with your legs crossed, and staying really well hydrated. I hope you have your blood pressure under control and have talked about anticoagulation with your Dr. Best of luck and have a great trip.
I have coped well with altitude before (Machu Picchu/Lake Titicaca) but that was before having this AF episode. I have booked into a hotel in Denver for the first 3 nights so will acclimatise before my son and I head off to the hills. I am not so bothered about when I am actually there, it's the flying. As everyone has said I must talk to my doctor about an antiocoagulant, I already have some lovely stockings! (is an Rx a prescription?)
Hi Annie know how you feel just had all those things you mentioned ( I am 63 in June ) and supposed to go visit my daughter in Sydney 1st September as she has just had my first grandaughter ! Met my 2 yr old grandson when I visited last yr , so we will both be devastated if I don't go (not even told her I am ill yet as did not want to worry her while pregnant ) she is due out of hospital today so will tell her in few days , I will be honest with you and say that even though I alphabet bought the very costly ticket I don't intend to go ! I am to cowardly , hospital took me off bisoprosol as even though I took lowest dose of 1.25. I was so weak and tired I could hardly function,he said 1 in 10 unfortunately react that way ,well although much less so I still have these bouts even after stopping so assume it is the condition itself ,he gave me a pill to take as and when which he said I will feel poorly for 8 hrs after use ,so all in all I can't face the very long trip . Told cardiologist of trip he just said come back to see him a month before ? I have echo booked for today too ! Not much h help to you I know and so sorry could not say Go for it ! As the doc never said it to me. But I AM a worried , go ask your GP see what he says ,good luck and keep me informed , do you feel unwell like me ? With lots of chest fluttering especially when lying down ? Best wishes Lynn
Hi Lynn so sorry you feel so unwell, don't give up on your trip just yet because you will get used to the symptoms, remember you can bale out at the last minute if it really is that bad. I know, I have been there and it will get better. Fear can paralyse but we do need to remember to breath through it and do things anyway, to use a quote! this is not the end of life but it is an adjustment. Hope you feel better really soon and keep posting. xx
Thank you so much for kind words , I have been really dizzy for last 36 hrs going to GP tomorrow if same , it's awful , can't even this.k further than tomorrow at moment !! I feel a coward not going but I know I am a worrier and won't have nerve to do it .
I am sorry you are feeling unable to travel to see your new granddaughter, I don't have any yet but understand how gutting that would be! I am at the very start of this condition, I do feel pretty unwell at the moment and don't know if that is the bisoprolol, and yes my chest does a fair bit of acrobatics at times, especially when I lay down! I am worried about the flying, but it is a chance in a lifetime= my son is playing rugby in the newly formed PRP league in the US, and I will get to see the last two games...they are top at the moment so should get to see them crowned champions, and then we have 3 weeks to travel before he comes back to the UK. I wish I had longer to sort it out- to get my tests done and the results back, but if I don;t go on May 1st there will be no point going! Good luck to you too, I hope you get to see your family soon. All the best Angie
In your shoes I would go but only if on warfarin or other anticoagulant. And of course discuss it with your doctor. I have a house in France and spent loads of time in the air going back and over. Also went to Tenerife. Not as long as your trip of course. I suppose the thing to bear in mind is that AF won't kill you but stroke will. Good luck.
I've been to Denver and the Rockies when I had AF and didn't fnd it a particular problem. I was on warfarin and I had my monitor with me. The AF didn't affect my trip much at all. We still did lots of activities.
One point I should mention about warfarin - I rather feared it before I was put on it but it turned out to be a lot easier than I was expecting. And the protection it gives against strokes is a real comfort (aspirin doesn't really do much - you get the same risk of bleeds without the same benefits).
We travelled up through Wyoming to go riding, then Yellowstone for kayaking, down to Arches for mountain biking and the slot canyons and then back across to the Rockies for some hiking in the Rocky Mountain National Park and Mount Evans. It was brilliant. But we did acclimatise to the height of Denver and the plateau (6,000 ft) first before going above 10,000ft. Have a great time - it's one of my all time favourite places!
Hi Mark - that sounds exactly what we hope to do! I already have 3 nights booked into a hotel in Denver to watch my son play rugby before we set off on our adventures! I have taken on all the advice about warfarin and will speak to my GP. It;s early days for my firm diagnosis and treatment plan, but I don't have much time before I leave, so may have to be a bit proactive! Thanks for the advice.
Flying is no problem, given everything the others have said, anticoagulants, fly socks, exercise, hydration etc. Denver is very high altitude, it's a mile high. Very different from anything in Europe so please take Grandmas advise and take time to adjust, for me it takes 2days before I can do anything in Denver, the slower you adjust the better you will be in the mountains. I always suffer altitude sickness in Denver, headaches, bad dreams, nausea etc do not exercise until these symptoms desist. But you may be ok, it's very individual. The very dry atmosphere is also a big thing, you will dehydrate much more quickly than in UK so always have a water bottle in your hand and keep sipping. Bisoprolol often make us breathless, especially walking up hill, so you will need to adjust to that and pace yourself accordingly, know what it is like at sealevel first so you will have an idea of the effect of altitude and AFl meds. Have really good insurance for US and declare your condition and what you are going to be doing, AllClear site are good for this but talk to them, don't just do the website, they said no to me originally but when I talked to them they but me in touch with a company who did.
Monitor yourself, I take a wrist heart monitor and I stop when my bpm rises above 112 as I know that may trigger an episode. Do you know about AliveCor? You may not have easy access to health care in the mountains so an ability to take your own ECG can be very useful in the wilderness. Know when you need help and when you can ride out an episode safely, talk to your GP, mine gave me quite precise boundaries of when to call help. I have had episodes in the middle of the Atlantic on a small yacht so calling for help was impossible anyway! I survived and didn't stop me sailing, just limited the type of sailing I could safely do. Did stop me diving unfortunately.
I don't want to scare you as I think this is absolutely doable, but know there may be limitations re the high altitude in Denver. I skied there and found I had to miss about 30% of the runs because of the AF & meds so just learn to adjust and you will be fine. I am 62 and have had AFib with AFl and ATachy for about 8 years diagnosed, but know I have had it for a lot longer.
Thank you Cdreamer...lots to think about! I am not too worried if I have to limit some of my activities at altitude, and I had already planned 3 nights in Denver to acclimatise first before heading into the hills, and you have given me a lot of good advice...I am so new to this I do not know how it is going to progress..but this trip can only happen May 1st or not at all as my son is playing rugby there and the season finishes soon. By the way...what is AliveCor?
It's an app that requires a smart phone, a case with two metal strips on it, you download an app and you are up and running. To take an ECG you rest the case onto your fingers and you can take your own ECGs. Look on the AFA site, they have a link and at one time they were offering them for a trial, don't know if that is still the case. Otherwise look at their website alivecor.com. My doctors have been really pleased with the tracings I have submitted to them, because my EP is in London and I am in Devon I email him directly from my phone an ECG if there is anything I am worried about, I find it very reassuring and so much easier than travelling to London. Not sure if the NHS would offer that service but the local cardiologists were also impressed with the results. Not everyone on this site have been able to achieve a good reading but a lot have, ring the AFA help line and talk to them about how their trial went. Very best wishes and don't be afraid to ask questions, there is always someone to share their knowledge and experience and it really helps to know there are others who really understand.
I have an episode about once a week. It has been well documented on here that I only take asprin. I fly about 3 times a year usually one to the states. My advice go for it
I too only take aspirin, am 54 and have PAF like you Angie but my blood pressure is ok.
I was only diagnosed in June 2012 with a very scary episode like yours, lasting 90 mins but fortunately caught on the Paramedic's ECG. My arms were twitching, chest jumping about and I was very lightheaded and jittery thinking I was going to die. This all began after a very icy drink on a hot day.
Can you remember what you did, ate or drank perhaps or getting up suddenly, immediately before your episode?
My heart rate is usually around 62 these days and can be 52 when resting which is probably why BP meds I was tried on prior to my AF diagnosis but for my 'palpitations', made me feel exhausted so I came off them.
I've been given Flecainide as a 'pill in the pocket' since my diagnosis, to take as and when but am yet to take one.
In case this helps you , I had lots of extra beats and palpitations and felt jittery inside for a month or so after my big episode but it did tail off and (fingers crossed at this point) I haven't had another scary episode since. I have not had my night time racy heart episodes for a long while either.
This could be due to the several supplements I now take daily, I've no way of knowing but I think it is. I did lots of research on AF which convinced me to try supplements, much of this info is on a US website called 'A fibbers'.
The most important supplement seems to be a large dose of Magnesium daily. I take 800g and that dose is usually fine for most people. Magnesium is known to help AF and I've read it's given intravenously in hospital to revert AF to normal sinus rhythm. Worth a try.
I know I have had something going on, or 'it' for over 10 years, including heart 'racing' and waking me in the middle of the night.
All of this went undiagnosed and was previously explained away as 'ectopic beats' and 'tachycardia' despite having many tests including; 24 hr ECGs, 24hr BP monitor, stress ECG and Echos. Perhaps my precursor to AF was only ectopic beats, I don't know.
Do you know about or have you tried doing any vagal manoeuvres when you feel your heart going fast or out of rythm in the night? They include coughing or taking a deep breath in and holding it. These seem to give the vagal nerve a jolt and can halt the AF.
When I feel my heart 'taking off', I always do a short deep cough or a series of them and that can stop it and normal rhythm resumes. Jumping up and down works for some people.
I have had several holidays since my diagnosis, with 10 hr and 8 hr flights.
With your travel taking you to the USA, I'm sure you should be at least as safe as being here. I think you will be fine.
Make sure you mention the AF to your insurance though.
When I go away I do make a point of looking up exactly where the nearest hospital is before I go, just in case.
I also have an extra scary thing hanging over me as my Mum died at 54, my age now, when I was 19, of a sudden 'heart attack', having had 'funny turns' and 'panic attack' for some years but she was never investigated. Did she have AF? I think so,probably. My Dad had high BP and both my older brothers do now but I never have luckily.
It all makes me more determined to go off and have these holidays.
Good luck with your tests, I hope you get a diagnosis.
Hi Fallingtopieces (tho you sound very together to me!)
Thank you so much for your very interesting reply, I haven't really had time to look into supplements etc but will do so soon. I am a great believer in self help, but think I will wait to research this more until after my tests are done and some sort of diagnosis given. I have not heard of vagal manoeuvres, but I did find that the second and third little episode were relieved by sitting up and taking deep breaths- so have discovered it for myself! Will now look into this further. In hindsight I have remembered that I had a dozen or so very brief incidences of feeling a bit faint - literally only 30 seconds or so, hardly long enough to notice- in the months leading up to my major AF episode. Other than that I have never experienced any palpitations, odd heartbeats, pains or any symptoms of high blood pressure (tho I hadn't had this measured for years!). I had not eaten anything unusual, and felt well, until I suddenly felt extremely unwell! (I did have a headache from when woke up that day, but nothing out of the ordinary).
I will be sure to notify my insurance company, tho I do not know if it will be better just to say I have AF which is under control rather than that I am undergoing tests and awaiting a diagnosis- I travel on May 1st so doubt this will have been done by then?
I can understand how scary that must be for you that your Mum died at the age you are now- and suffered from what sounds to be the same condition as you do (but undiagnosed). I guess the fact that you have a diagnosis and are able to take preventative measures, as well as have a pill on hand if needed, should bring some reassurance that the same will not happen to you- I hope so anyway! Like you I feel I should grasp opportunities to travel and enjoy life. Thanks again for taking the time to reply, it really is good to know there are so many helpful people around!
I actually decided to begin taking aspirin over 10 years ago when I first became aware that I had 'ectopic beats' and taking into account my Mum's heart related death.
Doctors, that's GPs and cardio consultants during that time(including the EP seen after my 'biggie' in 2012) have repeatedly told me that I don't need it and they always note down that I have decided to take it myself!
I take a mini 75mg one nightly and then before I fly off on holiday I take a full 300mg aspirin for 3 days and for 2 days after too. I read that somewhere years ago as advice for everyone/anyone flying over 4 hours so I just began doing it.
As far as I know, the only cons of taking aspirin is stomach bleeding but the pros are multiple in the way of other health benefits, bowel cancer among them.
I buy the mini aspirin with a coating to by pass the stomach.
It's not that I've made a decision to not take Warfarin, I've been told categorically that I don't need it.
First of all, let me say that I feel your pain at worrying about missing a holiday and seeing your son. But I want to emphasize 2 things:
1. Even if you only have a few episodes of Afib, you MUST go on blood thinners and not just aspirin IF YOU WANT TO AVOID HAVING A POSSIBLY FATAL STROKE. I deeply believe in personal choice in care of Afib (or other conditions) but you need to make an informed choice. When your heart goes into Afib, the chaotic beating often lets the blood pool in your heart and tiny blood clots form. Then the clots can easily be distributed through your body, leading to stroke. And if you want to know what's that like, go sit in the stroke clinic of your local hospital,it's heart-breaking for people to lose their independence, etc. I am not sure your doctor has explained that to you.
I had one documented case of Afib (in a hospital while I was there to get my gallbladder out). I had a TIA. That is ONE documented episode of Afib for about 18 hours.
2. If you read this forum(and I do, it's fantastic) you'll see that patients have to be very proactive. Some doctors still cling to the belief that a 'few' episodes of Afib don't make it worth putting a patient on bloodthinners, which of course carry some risks. It is not their body, though. There is pretty compelling evidence that doctors should be FAR more aggressive about giving patient blood thinners, even the newer ones that have fewer side effects, etc.
The best gift you can give your son is staying healthy ... I would get this all sorted out and get on medication before flying to the US. And you really don't want the nightmare of being in the US and having to go to hospital (I live in the US now). The care is great, but the billing will be a nightmare.
Take care, I don't want to be scary, but I do want you to be an empowered patient/woman/Mum. My mother has Afib and she was diagnosed only after a stroke. She made a good recovery, but it was very tough for her. I wouldn't wish that on anyone and certainly not a nice Mum like yourself flying thousands of miles to see her son!
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