Understanding the Risks of Flying with Atrial Fibrillation
Flying introduces several physiological changes that can pose challenges for individuals managing Atrial Fibrillation (AFib), an irregular heart rate. The cabin environment of a commercial aircraft is pressurized to an altitude typically between 6,000 and 8,000 feet, where the oxygen levels are lower than at sea level. This reduced oxygen can lead to mild hypoxia, potentially increasing heart rate and straining the cardiovascular system, which can worsen AFib symptoms or trigger an episode.
The dry air inside airplane cabins can also contribute to dehydration, which can increase clotting risk. Prolonged immobility during flights, particularly long-haul journeys, further increases the risk of deep vein thrombosis (DVT), blood clots in deep veins, often in the legs. For individuals with AFib, especially those not on anticoagulants, this elevated clotting risk is a concern, as a dislodged clot could lead to a stroke. Stress and anxiety can also trigger or exacerbate AFib episodes.
While many individuals with stable, well-controlled AFib can fly safely, certain situations present higher risks. Flying is generally unsafe if AFib is uncontrolled, symptoms are unstable, or a stroke has recently occurred. Additionally, individuals who have recently undergone procedures such as ablation or surgery for AFib may need to wait a period of one to two weeks before flying to minimize the risk of complications like thromboembolism. Consulting a healthcare provider is essential to assess individual fitness to fly based on the stability of the condition.
Essential Preparations Before Your Flight
Careful preparation is important for a safe journey with Atrial Fibrillation. Consulting a healthcare provider well in advance, ideally several weeks before travel, is important. This allows time to assess AFib stability, adjust medication, and determine if flying is appropriate, especially with recent symptom or treatment changes.
Carry all necessary medications, including blood thinners, in carry-on luggage to ensure immediate access and prevent issues if checked bags are delayed or lost. Keeping medications in their original packaging can be helpful, and TSA regulations generally permit pills in pill cases. Pack extra doses to account for unexpected delays or changes in travel plans.
Obtain a medical letter from a doctor explaining your AFib condition, current medications, and any implanted devices. This letter can be useful for airport security, airline staff, or in a medical emergency abroad. Some airlines may also require a “fit to fly” certificate. Before departure, identify AFib symptoms and what actions to take if they occur. Research medical facilities at your destination.
During Your Flight: Staying Safe and Comfortable
Maintaining safety and comfort during a flight with Atrial Fibrillation involves adopting specific strategies to mitigate potential risks. Staying well-hydrated is important, so it is advisable to drink plenty of water throughout the flight, while avoiding excessive consumption of alcohol and caffeine, as these can contribute to dehydration and potentially trigger AFib episodes. The cabin environment typically has low humidity, increasing the need for consistent fluid intake.
Regular movement during the flight is also important to help prevent deep vein thrombosis (DVT). This can involve walking around the cabin every hour or two, when permitted, or performing in-seat leg exercises such as ankle circles, calf raises, and foot pumps to promote circulation. Wearing comfortable, loose-fitting clothing and possibly compression socks can further assist in maintaining good blood flow and reducing the risk of DVT.
Monitoring for any changes in symptoms during the flight is important. Should symptoms of an AFib episode or other concerning issues arise, notifying the cabin crew immediately is the appropriate course of action. They are trained to assist and can contact medical support on the ground, such as MedLink, if necessary. Being prepared and proactive can help manage potential in-flight challenges effectively.
Airline Policies and Travel Insurance
Before flying, understanding specific airline policies regarding medical conditions is important for individuals with Atrial Fibrillation. Some airlines may require a “fit to fly” certificate from a doctor, particularly if there have been recent medical events, if special assistance is needed, or if there is any doubt about a passenger’s ability to complete the flight safely. It is advisable to contact the airline’s special assistance team in advance to clarify any requirements and determine if medical forms, such as a Medical Information Form (MEDIF), need to be completed.
It is essential to purchase comprehensive travel insurance that explicitly covers pre-existing medical conditions like Atrial Fibrillation. Standard travel insurance policies often exclude claims related to pre-existing conditions, meaning medical emergencies related to AFib might not be covered unless specifically declared and included in the policy. Declaring the condition, even if it might result in a higher premium, ensures financial protection in case of unexpected medical events abroad, including the costs of emergency medical care or repatriation.