Has anyone in the group travelled abroad since being diagnosed with afib?
I asked my EP and he said make sure you know where the hospital is (comforting)! Then I asked what to do if I had an episode on the flight, he said "Sit it out", scary as my heart rate goes stupidly fast when I take an attack.
I have a friend who also has afib and she took an episode in the departure lounge she was terrified on the flight home.
I so want to go back to Cyprus later this year but flying scares me especially as it's near a 5 hour flight. I just don't want it to rule my life!
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Flew all over Europe for races when I had AF. Just stay well hydrated, give yourself plenty of time so you have zero stress and for goodness sake enjoy your holiday.
I have flown to New Zealand at least half a dozen times since being diagnosed with AFib, never had a problem. Now we can travel there will be going in the winter.
We're pretty lucky with winter weather in North Island I very much enjoyed my visits to Tauranga great beach
Do not let AF rule your life, lots of folk fly with AF. A few tips, if your going somewhere unfamiliar, it really is a good idea find out where you can get medical attention in the unlikely event you might need it. Give yourself plenty of time at the airport because all rigmarole is more complicated than it used to be so it can take longer, so more time means less stress! Keep well hydrated, good for the system and more frequent trips to the loo will exercise your limbs. Make sure you take sufficient medication with a some extra, just in case there are any delays and if possible, keep them in your hand luggage. Copies of prescriptions might be useful just in case. The most important thing is that you enjoy yourself, so have a great time and don’t forget to send us a card…….👍
If you have fast afib, I can't imagine why any doctor would potentially want you to "sit it out" for 4-5 hours when there are alternatives.
Not medically trained and don't know your history, but I can just tell you what I would do and what many here do when they go into afib,
When I used to go into fast afib, I was instructed to take the calcium channel blocker diltiazem to get my heart rate down. Others here take a beta blocker like bisoprolol or metoprolol to accomplish the same thing. Some take a combination of both. You still might be in afib, but these medications can make it a slower afib which is a lot easier and safer for you. I would call your ep and discuss.
Probably too earlier for the flight, but another alternative are anti-arrythmic's like Flecainide which you can use as a Pill in Pocket. These usually require some testing first and I would certainly not try it for the first time on an airplane but something down the line to consider. But for now, ask about a rate lowering medication.
By all means enjoy your flight but I think you'll enjoy it more if you're prepared.
Jim
EDIT: Thinking about it more, ideally you wouldn't start taking any new medications on an airplane flight. But since the flight is later in the year, now would be the time to talk to your ep about a rate or rhythm control strategy you can use by yourself and then use it on the ground first. If that's not possible, only you know how you feel when you go into fast afib, so the question then is if this is something you think you could or want to handle for 4-5 hours in the air?
Thanks Jim, I am already on anti-arrythmic Sotalol (just increased to 3 times per day). I think this is a potassium channel blocker. I never understand why EPs recommend different meds
You mentioned before that your heart rate is "stupidly fast" when you go into afib. So what are your instructions when you go into afib at home, or is it just "sit it out"
I suppose that is ok if your episodes are always very short, however I couldn't imagine sitting out my episodes which can last for hours, sometimes days, where my heart rate is over 150. In the past, I always took rate control drug to bring my heart rate down to around 100 so I could comfortable and safely wait things out. Now, I use a Pill in Pocket approach with the anti-arrhythmic drug Flecainide.
Yes, ep's use different meds for different conditions and different patient profiles. But if Solatol isn't working well for you, maybe ask your ep about Flecainide.
Hi Jim, my heart rate is like yours and yes, it does go on for up to 48 hours and is very uncomfortable. I was told to 'sit it out' unless I had chest pains or breathlessness. I was told if I go to A & E (which stresses me even more) that they would monitor me until I converted which they did when I first started with afib.My EP is a top Professor who has had articles in the national papers being the first to pioneer robotic ablation, so I suppose I need to put my trust in him.
I cannot take flecainide, I had this prescribed when first diagnosed and it caused pro-arrythmia in me, hence this EP changed me over. He has just increased my dose to 3 times daily to try and stabilise me, fingers crossed. I do think I am becoming paranoid about it though, waiting for the next episode!
What medication was increased to "3 times daily"? Sounds like you're already on a rate control medication and maybe your ep doesn't want to give you more. BTW do you know your HR when in afib?
My HR is over 150bpm in afib and I just could not imagine sitting it out at that rate for two days. And even before I slowed my rate at home with rate control medications, the first thing they did at the A&E was to slow down my HR with basically the same drugs although given intravenously.
In all due respect to your ep, I would simply ask him if he can prescribe a PIP (pill in pocket) dose of a rate lowering drug when you go into afib to make you more comfortable. He may have a perfectly good reason not to, but can't hurt to ask.
Hi Jim, I am on sotalol which is a rate control and anti-arrythmic. He tells me that I am still on a low dose at 40mg 3 times a day and hopefully this will stabilise things. If not, then I could increase more (which I don't want to do as I don't like taking too many meds) or go to amodarone or ablation but the NHS waiting list is very long! I see him privately and he isn't cheap at £170 for about 15 mins but it seems to be the only way to get to see these EPs without extensive waiting. Goodness knows what I will do when I retire next year as I won't be able to afford him 🙃😉
Beyond my pay grade what other rate control meds (or even if you should) add to Solatol as a PIP to lower your rate further during an afib episode. But I'd still ask him the question. That is if you have any money left Glad you're at least on the wait list for ablations, because that sounds like a reasonable next step if the solatol doesn't address your issues and/or detracts from your quality of life.
Because they all have different ideas and patients have different physiology and different meds suit different people. I can’t take any of them so had no heart meds except anticoagulants since I had pacemaker implanted.
Wow, CDreamer, how did you manage that? I am terrified of getting heart failure but my EP says it would take a very long time at consistent high rates to do that.I think I am doubly scared as my dad had afib and took warfarin. He fell, hit his head and sadly died from a brain haemorrhage at the young age of 60 way back in 1988
So you have just identified 2 worry thoughts - watch the video and do the CBT.
It's not magic, you manage it by having psychological tools in your kitbag. I repeat - Positive mindset and developing techniques to manage anxiety will get you a long way!
I am in Cyprus now. Have to fly back for a week in July. Then back for 3 weeks. Have also travelled extensively around the world with persistent AF. Wear medical wrist band or similar. Carry summary of important medical info and find out where nearest A and E is. Take plenty of meds in case of delays etc and relax.
I started having AF problems in the past 30 years.
Early on I flew the New Zealand and back, since then I have lost count of the number of European flights I have taken.
I never had an AF episode on the flight but did whilst at the destination. As I suffer PAF (regular determining episodes) I was always able to revert my AF episodes to NSR each time fortunately.
I have flown many times since my AF diagnosis, sometimes alone. Yes I was anxious the first few times but I had a talk with myself and reasoned as to the chances of an episode would more than likely be caused by the stress of the "what ifs". I always download something to watch so my mind is focused. We cannot plan for the "what ifs", so don't let AF rule your life, get on that plane and have a great time.
I have permanent AF, and flying makes no difference to it. AFAIK if you do have an episode then it will be no different to being on the ground. Make sure you've got your meds, plenty of fluids to prevent dehyration (which is worse on planes) and don't look at the prices of the snacks.
Glad you're asking this as haven't flown due to pandemic. Did one short trip soon after developing AF in late 2019 and had no issues. I'd be following Flapjack's advice. List of meds, meds with you in hand luggage, know where nearest A and E is and check local protocols if you can. Give yourself loads of time and stay well hydrated.
Sounds like it is the stress brought about by your fear of flying that is the problem here, sorry to say. Have you explored relaxation techniques, such as yoga breathing, to reduce your stress levels? I flew to Australia and back between my second and third ablations with no ill effects at all, apart from boredom.
I had over 60 flights each of the two years before my ablations . I am frightened by flying but even more scared of missing out! But it did not seem to trigger the episodes.
I had one or two episodes on some flights but it was never a show stopper or an excessive issue.
Would it help to break the journey in two, that way you can relax more thinking even if worse comes to worst you will be that much sooner on the ground....also may work out cheaper?
I flew to America just after diagnosis in 2017, and again since then, plus a couple of flights to Europe. I too had an episode in the departure lounge, I’m sure brought on by my fear of flying ! My GP had said flying was not an issue with Afib, but that it would be a good idea to get INR checked whilst away ( hence finding a hospital or doctors surgery ), as any change of diet might affect it. He also said, with a smile, that because I was on blood thinners, I was probably at less risk flying than most of the other passengers !
Flown all over the world, had a few episodes in AF whilst in the air and had no problems. There is absolutely nothing you can do anyway so I never worried. The anxiety of ‘what if’ is probably your biggest problem because that and the stress of navigating airports.
As Bob says, keep calm, keep very well hydrated and up on your electrolytes - trigger of them all for AF and have a great time.
I really can’t understand the comment about the hospital unless you have serious complications or are very symptomatic with your AF?
I can understand your reservations, I was also very symptomatic with high HR. And you are absolutely correct - don’t allow AF to manage you, you manage AF.
Once on the day of a scheduled flight that I didn’t want to postpone I awoke in AF, it wasn’t as bad as it sometimes was so I decided I would just take it really slow, drive to airport and park and see how I was. I sat in the car, did some LSD (Long, Slow, Deep) breathing until my HR was under my alert limit (150) and then walked to the airport where I repeated LSD and rested for 10 mins. Then went through to the gate, hydrate, repeat LSD ready to board the flight. Go onto the flight, which on this occasion was a short 40min hop, sat down and kept very quiet. Converted to NSR during the flight and was absolutely fine. A calm, positive mindset and breathing techniques can get you a long way.
Take it one step at a time and know you can bale at any stage if you feel you aren’t well enough to travel. It is important that you manage your AF so develop a plan if you do go into AF and know that there intrinsically nothing dangerous about flying in AF if you have a plan and keep calm and leave yourself plenty of time. I always book assistance so I don’t have to queue as standing for any length of time for me was a sure trigger as I have very low BP so blood would pool in my legs if I had to stand. I rarely needed a wheelchair but the ‘walking’ assistance takes the very short walks behind the scenes to the plane whilst the other passengers walk about x5 the distance along long corridors designed to dilute the crowds.
CDreamer, thank you for your advice, you have made Mr feel so much better and less scared 😊 I too have low BP often only around 98/60 in a morning but never goes really higher than 110/70.I do get very anxious and worried, especially at night so I tend not yo have restful sleep! I awaken a lot thinking it's going to start (my last 3 episodes did in the night), I wake around 6ish and feel as though my heart is going too fast but not jumping around, I think the stress and anxiousness is doing this as the feeling goes when I get up. What are your thoughts?
I would suggest you research Autonomic Nervous System response and Vagal AF. It's important to get a handle on what could trigger your episode and everyone is different. I used to have nocturnal AF - that was triggered by sleep apnea. Treated the Sleep Apnea - no more nocturnal AF - but I still had AF. Moving too quickly and too fast after eating is a common trigger - eat smaller amounts and nothing at all for 3 hours prior to going to bed. It's a matter of experimentation and finding what works for you.
Worry & physical stress = systemic inflammation. Any systemic inflammation will trigger AF so first and foremost - manage the worry and the physical stress - CBTMindfulness which works with worry thoughts + body anxiety so works very well. Even if it doesn't stop AF entirely it will help you cope with episodes and the calmer you stay, the better you will cope.
I really like this video explanation of how it helps and Barbara is well renowned, experienced therapist. There are plenty of sources of help regarding CBTM in most areas.
Oh - just one tip - ensure you split your meds between hand baggage and hold baggage and ensure you carry at least twice as much as you will need for your trip. We were delayed in Maderia Feb 20 and my husband ran out of meds. We got them no problem but obviously had to pay and it was a faff finding a doctor, pharmacist etc but have to say - far more efficient than in the UK.
I’m glad you asked that, because I’ll be flying to Spain in September, and I am terrified in a plane. The only way I can do it is with a large glass of wine and a diazepam, which I doubt if I can do now with AF. Will be very interested in your replies.
I always take an ativan when I fly. Which they also gave me to help bring heart rate down along with iv meds when I was in the hospital after diagnosis. Maybe ask your doctor for the diazepam…
Thanks Ab. Doc did prescribe diazepam, but that was before the AF diagnosis, and now my heart beats too slowly, except when it occasionally takes off at a gallop. 🙄
I had the same concerns as I have booked to fly to Florida in November. My cardiologist said there is no reason I can't fly with Afib. He said to keep hydrated, wear flight socks, and keep medication in my hand luggage. I take amiodorone which will hopefully keep my heart in NSR.
Hi JonathanC I don't think I would be scared if I didn't have attacks that sends my heart rate soring! I usually self convert but not for at least 36 hours and at a heart rate of 150bpm it's exhausting
Well, I chose to ignore Afib and hope for the best while i travelled the wolrd including India and China. Life is full of change happenings. I am not telling you what to do. This is just my take on Afib and travelling.
I have had departure lounge onset of Afib on several occasions in the past probably, as back then, my fear of flying was contributing to the general stress of getting away on holiday. I found that sitting in a comfy seat sipping at water and managing my breathing could just as easily be done on a plane as at home. Distractions such as a good book or film helped enormously too. I wear a medic alert bracelet just in case, more for my peace of mind than anything else and am now happy to fly off anywhere as my fear of flying has subsided the more I do it. I too fly frequently to Cyprus, enjoy your holiday. Rosie
Iv been abroad lots of times since being diagnosed with afib. Bob hit the nail on the head by saying give yourself plenty of time. Because There’s nothing worse than rushing about at the airport.!
Just seen your post so a bit late to the party! I can't comment on flying as I get somewhat claustrophobic in a plane so with the onset of AF, fast and persistent about 29 years ago I have never flown ! We had cruise holidays instead. Getting panicky in a plane would make my AF even worse and I'm talking about rates up to and above 200 bpm which don't go down without intervention.
Having said that, if you're otherwise happy with flying then don't put your life on hold. It's easy for those who don't have particularly fast rates to say sit it out but that is not easy if yours is stupidly fast as you say.
We've still had some great holidays by sea visiting West Indies, Russia, Scandinavia and Mediterranean hotspots with only one AF drama coming back through the Bay of Biscay. I relaxed in my cabin with Bisoprolol until we docked!
Flying never triggered an a-fib attack for me, but jet lag certainly did. I was fine on my flight home to the US from Scotland -- it was long, with a couple layovers, after no sleep at all the night before flying -- but I went into a-fib in the wee hours of the morning after I got home. Advice, if you're asking, is to not overdo it before your flight and stay hydrated during it.
Keep well hydrated. No alcohol. It’s not a problem !
The actual flying has never affected me but a very early start can as can jet leg and fatigue. I try to never fly early morning because of this, earliest I’m happy with is a 7am flight which means being able to stay in bed till 4:30am as we try to stay at an airport hotel the night before. As others have said carry medication in hand luggage and I always put the spare in my partners hand luggage. If travelling via Dubai or Thailand always carry your prescription as some very common drugs are illegal without, saying that nobody have ever checked mine. I find the travel insurance the biggest issue to be honest and it’s ridiculous cost. Enjoy travelling.
If you would like further help regarding 'Travelling with AF', you will find some helpful advice in our AF Fact File on page 73 that can be downloaded from the AF Association webpage: heartrhythmalliance.org/afa.... We also offer travel insurance information too: heartrhythmalliance.org/afa...
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