Atrial Fibrillation advice please.

[deckchair]

Any commercial pilots out there with or know anything about Atrial Fibrillation? Is it career ending? Please only respond if you know what you are talking about. This isn't a laughing matter.

[ampclamp]

Is it paroxysmal atrial fibrillation or supra-ventricular tachycardia? Some tachycardias can be fixed relatively simply these days.Others of course are more problematic. Have you had a 24 hour holter monitor and identified the exact problem? Stress tested?

[Phororhacos]

If you were UK based, I would have suggested you look at this. It gives the current UK CAA view on AF.


http://www.caa.co.uk/docs/49/SRG_Med-AF_Jan_05.pdf

Then I noticed that your location was Qld, (Is that Queensland?)

edited after seeing OP's location

[teresa green]

Don't panic for a start. I have had it almost right thru my career, to the point that I could not lie on my left side without my heart start playing up, and missing beats. There are two types one dangerous if not treated, the other harmless. Mine was harmless but rather frightening at times, as I have got older it now needs treatment, and I require warfarin to stop clots. My career lasted 49 years so I imagine will yours. Get your self fully diagnosed, you will hopefully find your concerns are not as bad as you think.

[amos2]

Unfortunately Atrial Fibrillation is a major problem re a First Class medical.
Any DAME will tell you that.
However, that doesn't mean it will terminate your career.
Check it out now, don't waste time!

[HEATHROW DIRECTOR]

I can't imagine being on Warfarin would be permitted as it is potentially dangerous. My wife had AF for several years which was initially fixed with cardioversion which lasted a year. They tried cardioversion again and it lasted 24 hours after which they said there was nothing else they could do and she would be on drugs for the rest of her life. Being on Warfarin contributed to her early death.

[RIVER1]

I can relate to your concern as some 12 years ago I developed AFIB and had best part of a year off after which it was decided by the authority that this condition was manageable and I resumed my job as A320 captain with Ansett and my licence was conditional on being a co pilot or captain of a 2 crew operation.My condition was chronic AFIB and I still have it and recently went on to a new blood thinner Pradaxa,however it caused some complications and I am now back on Warfarin.There has been huge developments in the treatment of this condition and I am considering a thoroscopic maze procedure in Ohio that has apparently a high cure rate though it is very expensive due to no medical insurance cover from Aust insurance.It sounds as though you have recently been subjected to this condition and as such there are treatments available in australia with catheter ablation.Good luck with your career.

[teresa green]

I was only ten years old when diagnosed, after fainting at a school sports day. Yet was able to have a long career in Aviation as a pilot. A Aviation Doctor once told me that pilots with a known heart disorder and being a treatable one, are far safer than those who fly with undiagnosed heart disease, as heart attacks are more common in those who have not being diagnosed than those who have. Every checkup used to send my blood pressure soaring (white coat disorder) and I tried everything to slow it down, I found walking slowly around the block, and refusing to think of the consequences if failed, helped a lot. There are pilots flying after by pass surgery, who are considered healthy, so as the others suggest, get your self totally checked out, and remember that there are those who have gone before you and successfully kept working. Good luck.

[E&H]

I ended up on the operating table under anaesthetic having my heart hit with the Packer Wackers and I still hold a class 1...it didn't respond to the chemical treatment which is why they put the paddles on me...woke up feeling great...afterwards I was on some drug for about 3 weeks before I decided to take myself off of it...it made me tired and any exertion was out of the question...as soon as I came off that drug I started to feel better...to get my class 1 medical back I had to do a stress test, cardiac catheter which was an experience watching the dye flood through the blood vessels, holter moniter for 24 hours...mine started about 5 am when I got out of bed and lasted for 24 hours before it was fixed by the paddles...I had 4 beers the night before...the doctor put it down to the alcohol...I have never been happy with that as I had been recovering from a flu at the time and been working in very humid conditions and sweating a lot...I also had sleep apnoea at the time...so I think to just blame it on the alcohol alone really doesn't explain it, then again I'm not a doctor. I do however moderate my alcohol intake (never was a big drinker)

I guess it really comes down to what causes it...I have another mate who has had AF as well and he has his Class 1 back as well...

I have since had my heart checked and the Cardiologist told me that you can get it from going for a jog then coming back and having a glass of cold water...

[deckchair]

Thank you all for your replies - each one has been of great value. I appreciate it.

[Genghis the Engineer]

My dad was diagnosed with AF, which seems to have been caused by viral damage to his heart, in 1984 - he'd have been 43 at the time. It was severe, and hospitalised him for 9 months at no notice. *He* initially thought that he had flu !

Thanks to a superb NHS hospital, and a very loyal and caring employer, he returned to work about a year later, and continued to a normal retirement age - apart from a couple of patches when it got messy again and put him into hospital for shorter periods. My mum has staved off the occasional nervous breakdown as a result. He remains on a cocktail of drugs that I'm not qualified to talk about in detail, but have needed careful monitoring and adjustment and have occasionally had undesirable side effects (fainting at one point, and at another point turning his skin a rather dark shade incompatible with his caucasian ancestry.)

He's not a pilot, and never had to hold a professional medical of any description, but had in his youth been a very fit athlete (100 mile cycle road races anybody?). In all likelihood that residual fitness saved his life in 1984/5, but I doubt he could have passed a class 2, let alone a class 1, at any point in the last 28 years. On the other hand, he remains an active 70 year old now.

So with good medical treatment, at its most severe it appears to be treatable, but not curable. I think it certainly has potential to be career ending for a professional pilot, based upon my dad's experience - but clearly from earlier posts not necessarily and that must depend a lot on the detail of the individual's problem.

Dad was ordered to stop smoking (he had a 3 cigars a week habit!, but apparently even that was too much) and that he could continue drinking, but never afford to get anywhere close to drunk. He's stuck to that advice, and a regular low level exercise regime - and I have every expectation of his coming to my retirement party in 20++ years time.

In his late 60s he was diagnosed with mild diabetes, whether that has any connection, I don't know, but doubt it - I only mention it for completeness.

[airjet]

After flying for 45 years i retired in june 2010 and had my 1st attack of paroxysmal AF in july. since then i have had 2 more attacks, the second one after drinking 4/5 scotch`s which may have triggered it, however after that i completly gave up both alcohol and caffeine, and still had another attack, i believe the mistake i made was coming off the "tambacor" since last nov i have stayed on the drug and it has not happened again (so far), i went into hospital for the last 2 and since each attack caused my heart rate to go up(about 110=140) they controlled it with "cardizem" however the attacks got progressivly longer to control 1st about 10 hours 2nd 28 3rd 40.
In the hospital a nurse said that the FAA nowadays would stop u flying, but i went into the FAA`s website and it said that you could get your med back after a series of checks. My cardioligist also said not to get "dehydrated" (drink alot of coconut water) lol.
As regards the procedure where they laser a node, a friend just had it and it worked great --but--be careful with this as if any mistake happens your career is doomed. also as someone said its expensive USD 65.000.

[airjet]

As per above, if u have the paroxysmal type(which means not constant) i take a full aspirin every day, and when and if you are under attack you could take pradaxa(which is hellishly expensive)

[gcap]

I was diagnosed 2 years ago. I am in constant afib.. I hold a special issuance 1st class from the FAA. I take no meds other than 1 aspirin a day. I am asymptomatic. The need for anticoagulants is determined by your "CHADS" score.
C Do you have congestive heart failure
H Do you have hypertension ( high blood press)
A Are you over 75 years of age
D Are you diabetic
S Do you have a history of stroke or TIA
For the FAA, you must have a thallium stress test, echo cardiogram, and wear a Holter monitor for a 24 hour period.
After that, the flight surgeon will make a determination of your fitness for the appropriate class of medical.
Best of luck

[HEATHROW DIRECTOR]

I think treatements vary depending on your country. My wife would have answered "no" to all those chads questions but she was on Warfarin and it did not do her any good at all...

[airjet]

I think 2 baby aspirin (one at night and one in the morning) a day is quite good enough can`t see how eating "rat poison" (warfarin) could be good for you.

[homonculus]

Then with respect I suggest you ask your doctor

AF is quite complicated as can be seen by the various postings. New anticoagulants have recently been approved in the UK - very expensive in the USA but a few pounds here and free over 65. Mitt Romney may consider that dicing with the devil, but my patients are quite pleased to be able to get the latest socialist medicine without bankruptcy.

However there are numerous treatments such as ablation and cardio version and the best treatment for a particular patient depends on numerous factors and needs a face to face consultation with a cardiologist.

What is clear is that this is not ever a risk free condition and it should not be left