As the summer travel season takes off, patients who cope with atrial fibrillation (afib) might wonder how to treat afib while traveling and what risks traveling poses. We sat down with electrophysiologist Dr. Monica Lo (a physician who treats heart rhythm problems) to ask her about any risk factors with airplane travel or long road trips.
Q: What is Atrial Fibrillation?
A: Afib is an irregular rhythm (erratic firing) coming from the top chambers of the heart. Not everyone with afib feels palpitations; some people may feel fatigue, dizzy and not able to do as much. It’s a very common condition – 1 out of 4 people over 80 have it. However, afib patients can range from people in their teens to 90 year olds.
Q: It’s vacation season – what recommendations do you have for patients how how to treat afib?
A: People overindulge a lot on vacations. They forget they have a chronic medical condition. They eat excessive salt since they are eating out. Sometimes there is heart failure that is related to afib. A lot of times, it is fluid buildup causing afib rather than afib causing fluid buildup. If you eat excessive salt, that can bring about an afib exacerbation. If you drink a lot of alcohol on vacation, that can also be a trigger for afib.
Q: For afib patients that plan to fly, what suggestions can you recommend?
A: People worry that being in an airplane is going to trigger afib. It’s a pressurized cabin at about 5,000-8,000 feet. Airplanes have enough oxygen where that shouldn’t be a problem. You always want to check with your physician before going out of town. Make sure your condition is well controlled and you are on appropriate medication, and make sure you have your medications and refills with you. When traveling by plane, people can get very dehydrated due to cabin pressure and rushing around to make connections. Someone who is dehydrated can get into afib easily. To minimize this, drink plenty of fluids and give yourself plenty of time so you aren’t overly stressed or overly tired.
Q: Is it only airplane travel patients should worry about?
A: There is a risk of blood clots for some patients. Those with afib who are over 65, depending on their stroke risk factors, are likely on a blood thinner. If you have afib and have low risk factors for stroke and you’re not taking a blood thinner, you are at a higher risk for clotting. If you’re traveling by car, stop every hour, get out and walk. By plane, every 30 minutes, walk around, move around, that can prevent the risk of clotting.
Q: What about people with pacemakers?
A: If you’re on a blood thinner such as Warfarin or Coumadin and it’s a long trip, make sure you have some place that’s available to check your blood thinner level. If you have a pacemaker or defibrillator and you’re doing international travel, make sure there is somebody who would be able to check your device in case of an emergency.
Q: What circumstance can get patients into trouble?
A: When patients are doing well and they forget to take their medications or they stop taking them, that can cause problems. They may pass out from afib if they aren’t taking the correct medications. If they forget or miss their blood thinner, they may end up in the ER with a stroke.
Q: What about traveling to the mountain states – does altitude pose a problem?
A: If you are traveling somewhere above 8,000 feet, the recommendation is to stay in an area with lower altitude for five days or so and then climb up to a higher area that can help your body adjust to the altitude. Hydration is key.
To learn more about atrial fibrillation and how to treat afib, click here and listen to our podcast with Dr. Lo.