Being diagnosed with an arrhythmia doesn’t mean putting your life or your travel plans on hold. Many people with irregular heart rhythms fly, drive long distances, hike, cruise, and travel internationally without issue. That’s because they’ve addressed three big variables: how their arrhythmia behaves, the challenges of their destination, and the impact of their mode of transportation.
Travel itself doesn’t cause arrhythmias, but changes in routine, sleep, hydration, altitude, temperature, and stress can influence how your heart behaves while you’re away from home. A quick weekend road trip is very different from a long international flight or a vacation at high altitude.
With the right preparation and guidance, traveling with an arrhythmia is not only possible but enjoyable.
Scale of Severity
The severity, stability, and triggers of your arrhythmia say more about if and how you should travel than the diagnosis alone.
Some people experience occasional or intermittent arrhythmias, such as brief episodes of supraventricular tachycardia (SVT) or infrequent atrial fibrillation (AFib), that comes and goes. When these rhythms are well controlled, cause minimal symptoms, and haven’t changed recently, travel is usually safe.
Persistent or chronic arrhythmias, including ongoing AFib, ventricular arrhythmias, or rhythm issues associated with heart failure or prior heart attacks, don’t automatically rule out travel – but they do raise the importance of medical stability, medication adherence, and knowing what symptoms should prompt medical attention.
Someone with AFib who feels well, tolerates their medications, and hasn’t had recent flare-ups is often in a better position to travel than someone with a milder diagnosis that’s poorly controlled or newly diagnosed. Certain situations also deserve extra discussion with your healthcare team before traveling:
- Recent medication changes
- New or worsening symptoms (like fainting, chest pain, or severe shortness of breath)
- Recent hospitalization
- Recent ablation or device implantation
- Difficulty controlling heart rate or rhythm
No one wants to miss out on a vacation, but if any of these things are on the table, it’s best to chat with your care team and make some adjustments to your plans.
In addition to the severity and management of the arrhythmia itself, one should also consider the state of underlying health conditions.
- High blood pressure puts added strain on the heart; blood pressure increases and arrhythmias worsen with dehydration or exposure to extreme temperatures.
- Heart failure or structural heart disease can limit the heart’s ability to adapt to higher altitudes and environments you aren’t used to.
- Sleep apnea affects the heart as it is; when combined with disrupted sleep schedules, jet lag, or inconsistent CPAP use, heart rhythm can become less stable.
- Lung disease can make changes in oxygen levels more noticeable during air travel or at higher elevations. Hot, humid climates and cold, dry environments are generally the most challenging for people with breathing difficulties.
- Diabetes or kidney disease influence and are influenced by hydration and electrolyte balance; noticeable symptoms can manifest when routines, meals, or fluid intake change while traveling.
Because heat, dehydration, altitude, missed sleep, or medication disruptions can affect both arrhythmia behavior and the underlying condition, try to anticipate stressors that could push an otherwise stable condition out of balance while you’re away from home.
Travel Plans
You don’t need special permission (unless you’ve had a procedure recently) to travel, but you do want clarity on how your plans intersect with your heart health. A short conversation with your healthcare provider can go a long way – especially before longer trips, international travel, or destinations that push you outside your comfort zone.
You’ll want to discuss:
- Whether your current medications are optimized and stable
- Whether you have enough medication to last the entire trip plus extra in case of delays
- If your provider is willing to authorize early refills or emergency prescriptions
- Symptoms that prompt rest versus those that require medical evaluation
- Whether your provider can recommend a medical center or specialist near your destination
- How to handle missed doses, time zone changes, or delayed travel
- Whether any recent changes in your health affect your ability to travel
- Whether the area you’re traveling to has any health advisories to be aware of, especially any that can affect your heart or underlying conditions
Mode of Travel
Different modes of transportation stress the body in different ways; knowing that, you can plan accordingly.
Air travel is generally safe for people with stable arrhythmias, and flying itself does not cause rhythm disorders. That said, long flights combine prolonged sitting, dry cabin air, disrupted sleep, and other stressors that can influence heart rate, hydration, and clot risk. Staying hydrated, limiting alcohol and caffeine, indulging relaxation techniques, wearing compression garments, and getting up to move periodically are simple safeguards, particularly for people with cardiovascular concerns.
A few additional air travel-specific considerations:
- If you have a pacemaker or ICD (Implantable Cardioverter Defibrillator), carry a device ID card and let security know ahead of time to prevent unnecessary and prolonged scanning.
- Crossing time zones can throw off medication schedules, so plan your doses in advance, rather than adjusting on the fly.
- Changes in cabin pressure, vibration, and noise can make palpitations feel more noticeable. Find ways to keep your mind occupied and know what’s normal for you.
Hours of sitting in a car or on a train can increase stiffness, fatigue, and the risk of blood clots, just as sitting for hours on a plane can. But the benefit of road travel is the ability to pull over or walk more often, so try not to “push through” long stretches. People with arrhythmias that cause dizziness, near-fainting, or sudden fatigue should travel with a buddy and plan rest stops.
Cruises and travel to remote destinations add another layer: medical care tends to be limited. Ships or isolated locations may not stock specific heart medications, anticoagulants, or other prescriptions, and losing or forgetting a necessary medication can be difficult, or even impossible, to remedy once underway. Health stability before departure and good preparation are especially important.
Destination
Changes in altitude, climate, and local resources are worthwhile to think about alongside the beauty of the atmosphere and the activities you plan to engage in. Higher elevations are lower in oxygen, hot, humid climates or cold, dry environments zap hydration, and sudden temperature swings can trigger sensitive individuals.
Some areas of the world lack the same resources or hygiene standards you may be used to at home. Infections, foodborne illnesses, or dehydration can disrupt sleep, bodily processes, routine, and, ultimately, your heart rhythm – even travelers without underlying health conditions can be affected. For those with existing arrhythmias or other cardiovascular conditions, these disruptions can be more significant, increasing the likelihood of palpitations, fatigue, or medication-related complications.
Remote or rural destinations also tend to have limited medical facilities, pharmacies, or access to emergency care. Unfamiliar medications, language barriers, or differences in healthcare standards can be additional hurdles. Inquiring about these things beforehand can help keep you out of a sticky health-related situation. It’s worth mapping out nearby hospitals, urgent care centers, or cardiology clinics and checking whether local facilities can provide what you need.
Travel insurance with medical coverage, a list of local emergency contacts (embassies, consulates, or trusted local doctors), and making sure your accommodations allow for easy access to healthcare are all practical considerations.
Staying Organized
Even being slightly organized before you leave can impact how relaxed and confident you feel while traveling.
- Always keep your prescriptions in your carry-on bag or within easy reach in a car. Avoid checked luggage or trunks, where lost or delayed bags could leave you without the essentials. Bring enough for the entire trip, plus a little extra in case of travel delays and remote stays.
- Carry a list of all medications (including doses and timing), any recent ECGs or test results, and ID cards for implanted devices like pacemakers or ICDs to save precious time in an emergency. For international travel, have the generic names of your medications written in the local language.
- Brush up on being a little more tech-savvy. Set phone reminders for medications, bring portable chargers for devices, and download a translation app for medical reasons, handling unexpected situations, or even just to chat with the locals. You could also download an app that can monitor your heart and help you stay within healthy limits during your activities and excursions.
- Pack cardio-friendly items in addition to the “usual” travel checklist: electrolyte tablets, a refillable water bottle, a travel-sized blood pressure monitor, compression socks (great for the plane!), extra device batteries, a small first-aid kit, and a cooling towel or hand warmers for extreme temperatures.
While you’re packing and planning, you’re building an experience that anticipates potential challenges. When your basics are in place, you can focus on the fun: exploring, relaxing, and savoring new adventures.
Dr. Tordini is a part of Florida Medical Clinic, Orlando Health.
