To travel or not…

[Longdistancewalker]

I am very thankful to have found this group as it has provided considerable amounts of information that otherwise can be a challenge to find even with the internet at our fingertips.

I am a 55 year old man who was officially diagnosed with AFib in December 2021 after spending the night in the hospital with the classic symptoms. The ER staff tried a chemical conversion which shifted me from AFib to Flutter and then cardio converted me with the pads. Follow up care in Canada can be atrocious and I did not have a consult with a cardiologist before 6 months had passed. I was out on Xarelto by the ER department and my family physician upped my previous blood pressure medication which already included bisoprolol. Flash forward a year and in February of this year I had my first AFib event post cardio conversion. It lasted about 36 hours and was self-limited at the gym. In early June my city was blanketed with smoke from the forest fires and I stupidly went to play golf in it and had another AFib event that evening after eating some overly salty food. This event lasted 3 and half days and again was ended by a light gym session. By far my longest AFib event. I had two shorter events in the following week (30 minutes and 3 hours) both self limited and then have been symptom free for 3 weeks until last night when I was awoken with the now familiar pitter-patter of the heart. Due to my bisoprolol dose, my subsequent events after the cardio conversion have not involved fast pulse. It can hit 90-95 as a resting rate but often is about 80 but with very irregular pulse that I can sense.

my question is this: I have a long booked trip to Sweden and Norway in 10 days to undertake a moderate intensity walk for about 4 weeks. My family physician who I saw in early June did not seem overly concerned about me going. I don’t have a PIP solution as the cardiologist did not prescribe one nor would I feel comfortable starting that protocol right now so close to a trip. Should I go? The frequency of my attacks are increasing but does this mean inevitably that I am on a downward slope to more regular events? Thanks in advance for any comments or suggestions.

[mjames1]

With no PIP dose, you have to ask yourself how you would handle a 2-3 day episode out on the walk trail? Where would you go? How well would you be able to manage based on past events? Picture the hypothetical and then make a decision.

Jim

[lovetogarden]

You’re going on a 4 week walk? I’d want to be sure I had a PIP or something that I trusted to control the afib before doing that. Hard to advise though, you need to do what you’re comfortable with. Can you talk to your cardiologist about this?

[CDreamer]

I’ve travelled far and wide with AF and in AF. I have not taken any medication for 10 years. I’ve had AF in planes, trains and boats. I’ve skied and although I do have problems with Altitude, I survived. As long as you have good travel insurance, have a back up plan for medical emergencies and don’t get dehydrated or over exert yourself - I would go if your family physician and/or specialist is not overly concerned.

What do you call moderate intensity walk and would you be camping out or staying in hostels/hotels? Are you with a group or planning your trip solo?

It’s a very personal choice as to what you are happy doing.

[Desanthony]

AFib has never stopped me doing anything I want to do Long haul flights to the US and South Africa to spend months with my grandchildren and brother. Skiing in the US and all sorts of silly things including bungee jumping and parachuting (at my age!) in South Africa. With permanent AF and only on anticoagulants I am not too worried about anything. I have a friend who has paroxysmal AF and he also travels and is not on a PIP. Having said that he does nothing more strenuous than play golf and hike. It seems that over salty food and exercise in bad climactic conditions have previously triggered your AF so avoid over salty or spicy food when away. I would imagine the air to be clean and good where you are going so not much to sorry about with that. I don't know if you have identified any other triggers for your AF but avoid the common ones like caffeine, alcohol spicy and over salted food and try and be calm and avoid anxiety and rushing whilst traveling allowing yourself plenty of time to get everywhere without rushing. Hope you will be fine. Take it easy and enjoy yourself.

[Billblue in reply to Desanthony]

that’s the sort of answer we need just be aware of symptoms

[Longdistancewalker in reply to Desanthony]

thanks for your encouraging words. My triggers are the usual ones: alcohol (sometimes, but not always), salty foods (again not always), dehydration etc. Luckily for my hike it seems exercise and hiking seems to be the most reliable cure to bring me back into normal rhythm. My most recent event lasted 12 hours (triggered I think by an extremely smoky outdoor concert and unfortunate late timing of my regular medication) and was relieved during a 5 km brisk walk during which my heart rate spiked to 145 bps per minute for a few minutes and then dropped into rhythm during a short break and a HR of 90. I think I just need to get on with living and try not to obsess too much about it given the protection offered by my daily anti-coagulant and beta-blocker.

[Desanthony in reply to Longdistancewalker]

Yes that's always a good thing - just carry on as normal but do avoid those normal triggers and don't overdo things - it's easy to do and I still do it. Take tablets on time too.

All the best.

[OldJane]

I would do everything to see a good EP before you go, even if it means spending money and travelling to do so (you are in Canada, not sure what you need to do to see one). Rhythm seems to be your issue and there are rhythm PIPs but your heart has to be suitable. Good luck

[CDreamer in reply to OldJane]

The Canadian healthcare system is not great for AF treatment and there are few options to go privately in many states - we have had a few Canadians posting about this who have seen EPs in Europe - and been treated!

Could be a thought whilst in Europe? Don’t know anything about Swedish system other than they have twice as many doctors than in UK (and I would guess Canada) with much better outcomes. Might not be a bad place to have AF - if you had very good insurance?

[mountainwalk]

I have just finished 12 days walking in the alps, 120 miles, 40,000 ft ascent/descent and 75 years old. Some people said don't do it others said go for it so that is what I did. My AF doesn't sound as bad as yours but you won't know unless you try and unless you do something stupid, you shouldn't come to any harm.

[Jajarunner]

Id goif you can get decent travel insurance... Have fun x

[2learn]

Who are you walking with and what is their expectation. My experience is good walkers do not want tobe slowed down or look after someone in distress. Also who defines moderate intensity, if its a regular fit walker they may regard 10mls up hill as a stroll.