AFIB AND TRAVEL

I am 71 and I have had a fib for three years. I have had three episodes about one every year and they generally last for about four hours and then convert on their own.

In April I am supposed to drive down to Iowa to see a friend. It’s a 4 Hour drive through farm country. When I get there it’s a small town without any large medical facilities.....I Know I would not be very comfortable if I had to go to an E. R. there.

This is the first time I’ve thought about travel. What happens if I am in the middle of nowhere and have an attack or what happens if I’m staying overnight in the small town and get an attack that doesn’t resolve without any big City hospitals nearby..... I have chosen to use beta blockers and not take anti-arrhythmic‘s. Is it smart on my part to drive by myself?

Does a fib stop anyone from traveling? Do you get nervous about traveling. I’m not sure how to approach this except I know I’m anxious about it... what else is new.

Thanks for listening.

Go! Go travel and live your life. Do not waste your time worrying about if and when your next Afib episode will happen. If you are worried about an episode, talk to your cardiologist and request a “pill in the pocket” such as Flecainide that you can take. Also, if you are not on blood thinners, you may want to get a prescription for Xarelto to have on hand if your Afib lasts more than 48 hours.

I travel the world. After a 16 plus hour flight to Queenstown, New Zealand, I felt off and bam, I was in Afib. I was on Sotalol at the time and took an extra half dose. It resolved itself after 76 hours. The Sotalol kept my heart rate in a manageable level between 80 and 120 BPM. I continued to carry on with my trip and had some great hikes on the Milford Trek, albeit at a slower pace than normal. By the grace of God, I had thrown in a bottle of Xarelto that I had from a year earlier (I was off of it since it had been a while since I had a long episode of Afib). I started the Xarelto which I felt protected me from the 76 hour Afib episode and an extremely long flight back to the states. This happened late 2017.

In January of 2018, I had a weeks long episode, had to be cardioverted and decided on an ablation. Three weeks after my second ablation in June 2018, I went to Iceland. I refuse to let this control me and who I am.

My advice to you is to go, and enjoy. If you do go into Afib, you will have a plan to deal with it. Enjoy Iowa!

I Ditto what MissSunshine said Ids001!

When I lived in Amsterdam for four years I had to fly round trip from my long-term home in Honolulu to AMS and back four times a year (every 3 months) to renew my Dutch visa. In the first two years, I often was still in AFIB during those very long flights (approx 16 hrs in the air). This was before my index ABL with Dr. Natale in Austin ended my highly symptomatic persistent AFIB.

I had a couple flights with 150+ HR through much of each flight at a time when I wasn’t getting much help in lowering my HR with Beta blocker drugs.

With only your typical four hour episodes of PAF you don’t really need to go to the ER ... not unless your AFIB becomes very fast and with shortness of breath . Sounds like you can control your rate okay as it is.

Take it easy Ids001 when, and if, an episode hits while you are on the road, but relax too and don’t let AFIB boss you around ... you should do fine and enjoy your vacation!

Best wishes on your Iowa road trip!
Shannon

I travel all the time. In fact am on a trip right now. My protocol includes PIP (on-demand) flecainide to convert me when I go out of rhythm. I do bring this with me. I don't use a beta blocker with it. There is a risk the flec could bring on high rate flutter, though this has not happened. Though my episodes are infrequent, I have used the flec for 14.5 years in this on-demand fashion. I've gone out of rhythm and taken the flec in some interesting places - in a snow cave I'd constructed where I used water from a partially frozen water bottle to chase down the flec; in a tent at the base of 14,000' Mt Crestone, where I was planning to ascend the next day; several days into a backpacking trip and after climbing the Rio Grande Pyramid (13,825'). Though I didn't have an episode, I did a two week paddle raft trip on the Colorado River through the Grand Canyon. If I'd had an episode requiring medical care there, it would have required a helicopter evacuation. I have considered, but never gotten, medical evacuation insurance for trips that are more remotel. Constructing the snow cave and climbing the peaks fall into endurance exercise which can be a delayed vagal trigger for me. I've gotten better over the years at avoiding those endurance exercise triggers.


Go enjoy. If it is a 4 hour drive - then you can always drive home, unless your afib is symptomatic enough to prevent that.

George

So, my doc has always said if it lasts more than eight hours I need to go to the hospital, but that is because of blood clot potential.
I have Eilquis at home...that i have not used....take that with.
So if I’m on my trip and my AFIB starts up .....do what I normally do, and live my life....... if the symptoms aren’t too bad. And if it lasts more than seven hours or so start taking Eliquis and keep on with my beta blocker. I don’t/won’t have a PIP rhythm drug.
It doesn’t resolve I have options. I can come home.......
I am still so much into the anxiety of it.....I wish I had your guys attitude.......so laid back about it...how did you get there?

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lds001
So, my doc has always said if it lasts more than eight hours I need to go to the hospital, but that is because of blood clot potential.
I have Eilquis at home...that i have not used....take that with.
So if I’m on my trip and my AFIB starts up .....do what I normally do, and live my life....... if the symptoms aren’t too bad. And if it lasts more than seven hours or so start taking Eliquis and keep on with my beta blocker. I don’t/won’t have a PIP rhythm drug.
It doesn’t resolve I have options. I can come home.......
I am still so much into the anxiety of it.....I wish I had your guys attitude.......so laid back about it...how did you get there?

I'm anxious too. I've had one episode (only one that I know of, but definitely only one ever recorded on EKG) in late November. I took Eliquis until a few weeks ago when I had my 1st appt. with an EP. He told me that I was a CHADS 1 and that I should not be on Eliquis.

Anyway, I was happy about that, but still SO very anxious about when/if the next episode happens. I remember the 1st one and how scary it was for me. I'm afraid that when/if I have another episode, I will panic thinking......"what if this is not Afib"?? The EP did tell me to take an Eliquis and just "wait it out". (Do they know how Afib feels?!)

Many things make me anxious - just having Afib itself. Reading about my higher risk for stroke. Reading about cardiac arrest and how that's an "electrical" problem.

So....interested in the replies you will get on "how did you get the laid back attitude"

But.....listen to the others....they give you great advice and I hope you enjoy your trip!



Edited 1 time(s). Last edit at 03/18/2019 05:30PM by katesshadow.

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lds001
I wish I had your guys attitude.......so laid back about it...how did you get there?

My first afib episode, I didn't know what I had and went to the ER. Realized then, that for me, afib is not an ER event. I created a plan to deal with afib, which was accepted by the EP (it was my plan, not his) 14.5 years ago. It has evolved to include detraining from endurance activity, remaining fit, electrolyte supplementation (magnesium to bowel tolerance, potassium and the supplement taurine), keeping calcium intake from diet <600mg/day, keeping insulin low through diet and fasting and PIP flecainide when the previous fails. Fortunately it works, and I go on with my life. I know that an episode might not convert, I might need cardioversion, I might get high rate flutter & etc. at some future time. If that happens, I'll deal with it. My attitude stems from my sense of control. While I can't completely eliminate episodes, I can minimize them and I know how to convert them when they happen.

lds - I echo all the great advice you have been given.

I, too, traveled and many times by air and with afib and sometimes, a-flutter. I always had close at hand, all of my meds along with those that helped keep me calm and I also made sure I was well-hydrated during and after the flight.

My events were often as long as 20 hours and sometimes, 24 - 28 hours. I was using nattokinase and pycnogenol as part of my blood thinner protocols and didn't have problems with clot formation. Sometimes, when I arrived home, I'd have to call for rapid assistance for Electrocardioversion because back then, the rule was not to go longer than 48 hours w/o having ECV.

Early on in my AF journey, I managed to feel that during AF, I was 'in control' and protected by all the positive measures I was using and that helped me reduce the anxiety factor significantly and often, I felt that the sense of calm helped me to stabilize and convert more quickly... and when I did not, I relied on my various distraction techniques to blunt the anxiety.

Have an enjoyable trip. At least since you are driving, you can stop, relax and re-group.. .or as George says, you can always go back home.

Best to you,
Jackie

I concur with everyone's comments on traveling Ids001! We have made several automobile trips between Las Vegas and Reno, a distance of 430 miles of which 380 miles is absent of pretty much anything other than sagebrush and Area 51. If you have a smartphone you may want to consider getting the app "Photo Afib Detector" which will evaluate and quantify any Afib symptoms you may be having before you depart. Enjoy your trip, LasVegas-Roy

Another person who travelled with paroxysmal AF. I flew all round the world as a scuba diver, remote places like Papua New Guinea, Vanuatu, Palau, Yap etc. I didn’t take any medication, just used to sit out the dives when I had AF and jump right back in the water when it stopped.

When the AF became long term persistent of course I stopped diving, but 3 months after ablation in Bordeaux I was underwater in the Maldives seeing 3 whale sharks in a single day.

Don’t let it interfere with your life.

Gill.

GOD BLESS YOU ALL! I can't begin to describe the comfort and ease of my anxiety by reading your posts. I'm 66yo and deal with every moment worry just thinking when is my next AF episode! Had my first in 2005 lasted 10hr & prescribed aspirin; second AF in 2018 lasted about 12hr. and prescribed eliquis, flecainide and Diltiazem. If I'm playing with grandkids or my pups and my heart starts skipping, I think 'this is it'!
You have given me strength to get on with life and not worry as much.

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Muntz
GOD BLESS YOU ALL! I can't begin to describe the comfort and ease of my anxiety by reading your posts. I'm 66yo and deal with every moment worry just thinking when is my next AF episode! Had my first in 2005 lasted 10hr & prescribed aspirin; second AF in 2018 lasted about 12hr. and prescribed eliquis, flecainide and Diltiazem. If I'm playing with grandkids or my pups and my heart starts skipping, I think 'this is it'!
You have given me strength to get on with life and not worry as much.

Wow - 13 years between your 1st and 2nd episode!

I understand your anxiety - I had my 1st episode in November 2018 and it also lasted about 10 hours. Since then, I've been on edge also. If my next one is not for 13 more years, I would be happy (happier if I never had another one, but.......)

Take care and Welcome!

Thanks for the kind words. Unfortunately my Drs say since I'm older now and since AF is progressive the chances are great I'll have them more frequently. I guess that's why I live everyday in fear that each skipping beat is going to cause another episode. Just reading about others going on with their lives regardless of what might happen, is so uplifting! I find reading this forum and my bible keeps me strong!