AF AND CRUISING

[dgex2010]

Hello to all of you out there! Has anyone experienced AF whilst on a Cruise and if so, how were you looked after on board during an `episode`?

[meadfoot]

Hello. I have fortunately not had an AF episode while on a cruise. I have just been looking at cruises which have come through to me on e mail and I am constantly being asked to go on another cruise with some wonderful friends who we met on one of our several cruises.

However given the severity of my AF episodes which require hospitalisation and become worse with each episode I dare not now risk it much to my sadness. If your episodes are severe, as with any severe illness on board, you would most likely be put off ship at the next port and transferred to hospital.

The bigger ships with excellent medical facilities are still loath to keep patients on board if they think a hospital stay is needed.

However if your AF does not give you much trouble you may well be ok with the medical care on board. I have a friend who managed to sit out an episode while on a ffiords cruise but did not ask for medical assistance.

I would look at the medical care available and ask the question of the cruise provider for peace of mind. All ships are required to have a doctor, life saving equipment and medical facilities. The newer and larger ships are much more likely to have the best equipped medical and diagnostic services.

Make sure your travel insurance covers cruises which seem to have additional costs attached recently. Medical care on board is very expensive.

If you feel safe and secure with dealing with your AF then go for it. I love cruises and have had some wonderful amazing holidays, just miss them now so much.

I too am interested in other forum members experience of cruise medical assistance.

Perhaps we AF'ers could charter a ship with medical facilities equipped to look after all our eventualities so we could all get together and have a whale of a time in a safe environment lol.

Dont let AF rule your life (sadly I do due to its severity) so take a leaf out of my book, dont let it and go for it if you want to.

Kind regards

[dgex2010 in reply to meadfoot]

Thankyou so much for your response ...... very helpful and encouraging indeed. You`re quite right - if AF is manageable then it shouldn`t stop us from enjoying life - love the idea of chartering a ship for fellow sufferers - if only. Anyway, thanks again and you take care. x

[sunigirl]

Hi. I went on a Mediterranean cruise in 2012. I did have an episode of AF which lasted approx 18 hours. I take it easy and just wait for it to pass but the medical facilities are brilliant and I would have every faith in them. If you do decide on a cruise you will have a wonderful time. Susan N.

[dgex2010 in reply to sunigirl]

Thanks to you for replying - sound like you had a lovely cruise. I have been on cruises over the years and must admit that I just love being on the sea - even when its rough! Must be the Piscean in me! Must give it some thought. Take care x

[Uttled00]

Did my first cruise last year and enjoyed it so much we have booked to go again in August with my family. My af episodes, while annoying, are by no means dibilatating ( touch wood) so am relatively relaxed about it. But I will be making sure I have the appropriate medication with me just in case.

[dgex2010 in reply to Uttled00]

Thanks for that. What medication would you be taking just in case? I`m on the beta blockers and anti coagulant for my AF but haven`t been prescribed anything else. Thanks again. Dorothy. ps,,,, I think that cruises are a bit like Marmite, you either love them or hate them - I was hooked on them at a very early age - my parents introduced me to them when I was in my early teens!!

[BobD Volunteer in reply to dgex2010]

Maybe you need to talk to a different doctor like an EP as you are not being treated for AF, only some of the symptoms and stroke prevention..

[dgex2010 in reply to BobD]

Thanks Bob. To see an EP do I have to get a referral from the GP?

[BobD Volunteer in reply to dgex2010]

Step one.-- find an EP near you from the list under Patient information on the main AF-A website and then ring and ask for a private appointment. You will need a letter from your GP as well. You may be able to get NHS from the start but many people have found it quicker to go private for the first consultation and then revert to NHS. Don't be put off by your GP this is your right.

Bob

[dgex2010 in reply to BobD]

Thanks Bob - will follow this up. Dorothy

[Uttled00]

I will be taking Flecanaide and Bisoprolol. I am lucky enough at this stage to be able to cope, well most of the time, with using a PIP regime.

If I stay away from too many beers then I am hoping I will be fine. sunshine, beautiful places to visit, no stress etc etc doesn't sound like an afib rich environment to me...lol

[dgex2010 in reply to Uttled00]

Thanks for that. Sorry about the beers!! :0(

[Thomps95]

I went on a cruise and got extra medical insurance for a "pre-existing condition" through my AMEX credit card - they had an affiliate insurer and it cost me $45 AUD. I took with me beta blockers (took a quarter tablet on a few occasions, after a big meal and some wine) and apixaban in case of an episode. I'm already on flecenaide. I had no episodes on the trip, and if I did have an episode, it would not have been a huge issue.

[dgex2010 in reply to Thomps95]

Many thanks for reply - very helpful.

[BobD Volunteer in reply to Thomps95]

Why only taking apixaban when you have an event? If you have AF then you should be taking it all the time. How do you know you are not having silent events you are unaware of?

Bob

[Thomps95 in reply to BobD]

Thanks for asking - I recall you asked the same question a while ago so here goes again! I'm all in favour of anticoagulation as a prophylaxis, but my absolute risk is already extremely low - It gives me peace of mind to have apixaban as an additional "pill-in-the-pocket" safeguard, but I don't take it daily because it isn't recommended given my risk level, and conversely I'm at high risk for complications related to regular anticoagulation.

As for silent episodes - it's possible but as a check, I've had at-home heart monitoring on several occasions across lengthy periods of time (up to a week). No "silent events" ever showed up in any of these tests, day or night.

I've sought the opinion of several leading cardiologists and EPs on the matter: none recommends daily anticoagulation and based on my reading of the existing research I agree with them. If my condition worsens, or other stroke risk factors appear (e.g., with age) - I will have some difficult decisions to make. At this stage, though, my treatment has been well thought through

[BobD Volunteer in reply to Thomps95]

I understand what you say but wonder about the efficacy of taking anticoagulation after the event. The delay in getting into your blood stream may be sufficient for a clot to form would be my worry. Since you are happy with it that is all that matters.

Bob

[Thomps95 in reply to BobD]

Apixaban is fast acting, unlike warfarin which has an effect only over a period of several days. My understanding is that the probability of a blood clot forming is close to zero in the first 5-6 hours of an episode, and starts to gradually increase only after about 24 hours. The advice of my EP was to take it at the onset of an episode and for three days after it stops. It's interesting that there is still quite a bit we don't understand about stroke. We have a logical model of AF and stroke, which is blood pooling. This sounds like a huge problem for stroke but actually, the body can normally deal with the condition - it seems circulation is not the body's sole defense against clot formation. A number of conditions need to line up. That's why, for example, one's age and other health conditions matter. In one study published in the Lancet, hypertension was the biggest predictor of stroke. Atrial fibrillation was the most common *cardiac* source of thromboembolism, but the prevalence of cardiac causes of stroke was relatively low in that study.

[Offcut]

I have multi conditions and have found travel insurance to cover all my conditions is far to high so I will not being going out side the UK. However I did look at cruises and did a lot of research and I did find from what I have read that anything outside of general practice people were taken off the ship and treated in the nearest hospital? So it could be a bit of a lottery as to how their service is?

However if I had only the AF and Tachy which I had back in 1992 up to 2008 I did go abroad with a slight increase to cover the "issues" without to much expense. If in AF while on holiday I just slowed down to a snails pace until it past or was not a problem.

Enjoy the cruise.

Be Well

[dgex2010]

Thankyou so much for taking time out to reply. Sorry to hear that you now feel unable to travel outside the UK but I understand your reasons and would be the same. I will ask the holiday company a few suitable questions too, then hopefully will be able to make an informed decision. Thanks again and stay well. Dorothy.

[Hidden]

Hi Dorothy - I suffer from episodes of persistent fast AF, in spite of 3 ablations, but still go on cruise holidays. A bit like Russian roulette really ........!

I didn't seek medical assistance on the one occasion when I became a bit concerned as we were only 36 hrs away from home port. I woke in fast AF ( about 140/170 ) & rested in my cabin most of the time taking extra Bisoprolol - to no avail.Arranged priority disembarkation & went back into NSR later in the evening at home. My GP

was not impressed .... said that I should have sought medical advice onboard

Mostly though I have been fortunate . I just don't drink alcohol ( or very little ) & try not to get overtired as these are triggers.

Make sure that you have adequate insurance in place, declaring all your history, not just AF , however irrelevant it may seem.

I shall make a point of asking one of the medics onboard next month what their policy is regarding AF patients & report back if it is of interest.

Sandra

[dgex2010 in reply to Hidden]

Many thanks for that - I`ll be interested to learn what the medics on board say! Look forward to hearing from you again. Dorothy

[yoyo_again in reply to Hidden]

would be interested in your response Sandra

[dgex2010 in reply to yoyo_again]

Hi there. Have just been on a med. cruise - Royal Caribbean ship Anthem of the Seas - launched April this year. Whilst I didn`t need to take advantage of their medical facilities, prior to sailing I had established the situation regarding blood tests. Apparentlly they are able to do INR tests on board if required. So good result eh. I would imagine that different cruise lines have different policies/facilities so would check before booking.