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Jughandle 02-26-2020 12:54 PM

Atrial Flutter
 
Anyone have any experience with atrial flutter corrected with cardioversion ? if so what were your best resources to get through getting back to work ? looking for testing, time frame, special issuance, etc. I am looking for any advice to help and move forward with sending to OKC aeromedical branch.

Thanks in advance !

Excargodog 02-26-2020 02:28 PM

See pm
filler

TOGA Thrust 03-17-2021 07:19 AM

I had AFIB first time was about 4.5 years ago. Was converted, went on flecainide back at work in a bit over 30 days. (I had a great AME, she pushed the FAA to issue the SI) Second time was about 26 months ago. Converted, went on Multac, back at work at about 34 days. Awesome AME called down to FAA and as she said the “right” doctor answered the call and told her to issue.

In November 2019 had third Afib and bit the bullet and did the ablation - antiarrhythmics werent cutting it anymore. FAA requires 90 day sit after ablation then multiple tests. It took 168 total days (from diagnosis to having medical in hand) to get back to work.

In October 2020 got a-flutter. Another ablation and am still out. First ablations are about 75% effective, second ablations are about 90% effective. We’ll see. I have been out 168 days to date and have been waiting for a decision from OKC aeromedical for four weeks.

Unless necessary I wouldn’t do anything more than required by the FAA. Ie cardioversion, 24 hr holter, stress test and echocardiogram (for first time SI, after that only 24 Holter required) Your cardiologist needs to fully understand the FAA requirements regarding AFIB. You don’t want optional stuff that he/she would do with a patient who has a ‘normal’ job. I would NOT want an implantable device continuously monitoring my heart.

Guide for AME’s regarding Afib: https://www.faa.gov/about/office_org..._classes/afib/

There’s a saying Afib begets Afib so here’s a public service announcement:

About 10 percent of the population has Afib. One of the four lifestyle changes one can make is treating OSA. If you think you have it, I would strongly suggest doing a sleep study. OSA is extraordinarily hard on your heart. I use my CPAP about 99 percent of the time.

Two - weight loss, yes it ain’t fun but you’ll feel better and look younger. Start at losing 10 percent of your current weight, then go from there.

Three - limit or stop alcohol consumption, yeah that ain’t fun either but alcohol is very hard on your heart.

Four - get some exercise, no you don’t have to run five miles every day, just get out, get a dog, go for some walks.

If you do those four things and still have an arrhythmia reoccurrence you will have done everything on your part to help your Doctors do their part.

FltChk 04-02-2021 12:51 PM

I also had episodes of atrial fibrillation in early 2019. Got stable with Flecainide and Metoprolol. Went through all the required tests for the Special Issuance. Once my Cardio Doc got me on the right combination of mg’s and stable in 30 days. My flight doc in OKC issued me my SI in a week.

I’ve had a renewal since then, and about to get one soon in May. The SI specification sheet outlines the reqs for your yearly renewal. Yearly 24hr Holter monitor and doctor’s note.

Good luck and PM if you have any questions.

METO Guido 06-23-2021 07:16 AM


Originally Posted by TOGA Thrust (Post 3208129)
There’s a saying Afib begets Afib so here’s a public service announcement:

About 10 percent of the population has Afib. One of the four lifestyle changes one can make is treating OSA. If you think you have it, I would strongly suggest doing a sleep study. OSA is extraordinarily hard on your heart. I use my CPAP about 99 percent of the time.

Two - weight loss, yes it ain’t fun but you’ll feel better and look younger. Start at losing 10 percent of your current weight, then go from there.

Three - limit or stop alcohol consumption, yeah that ain’t fun either but alcohol is very hard on your heart.

Four - get some exercise, no you don’t have to run five miles every day, just get out, get a dog, go for some walks.

If you do those four things and still have an arrhythmia reoccurrence you will have done everything on your part to help your Doctors do their part.

#3. Ignored and flew through this for a very long time. Whatever the cause, palpitations are a speed clacker. Immediate action required.

rickair7777 06-23-2021 09:19 AM

A good buddy had to get ablations, it worked out with the FAA but IIRC he had to do it twice.

That was a wake-up call for me... his condition was due to too much sustained hard cardio exercise while not being young. I got a heart rate monitor and lo and behold my moderately hard routine runs had me pegged above the max heart rate for my age... not good.

I apparently slow-boiled myself by doing the same running I had been doing for decades, without regard for aging. Didn't really notice that it was getting harder on my body but my heart did. Backed off and now reference the fitbit to keep heart rate in the recommended range. Actually feel better with the slower runs.

Turns out you can still do max effort interval work without over-developing the heart, just keep it to short intervals.

So too much isn't good either, all things in moderation.

WhisperJet 06-24-2021 06:36 AM


Originally Posted by rickair7777 (Post 3253637)
A good buddy had to get ablations, it worked out with the FAA but IIRC he had to do it twice.

That was a wake-up call for me... his condition was due to too much sustained hard cardio exercise while not being young. I got a heart rate monitor and lo and behold my moderately hard routine runs had me pegged above the max heart rate for my age... not good.

I apparently slow-boiled myself by doing the same running I had been doing for decades, without regard for aging. Didn't really notice that it was getting harder on my body but my heart did. Backed off and now reference the fitbit to keep heart rate in the recommended range. Actually feel better with the slower runs.

Turns out you can still do max effort interval work without over-developing the heart, just keep it to short intervals.

So too much isn't good either, all things in moderation.

Running, for as good as they say it is has, has destroyed my back, hips, knees, etc. I now walk (10,000 steps / 5 miles a day total) and I've never felt better or been healthier. Also ditched the heavy workouts and focus on core exercises and body weight (chinups and pullups). No need to squat 350 anymore/

AirBear 06-27-2021 11:29 AM

I haven't had any heart issues but I am diabetic on insulin and wear a continuous glucose monitor. With that I can see a graph of my glucose levels and quickly see what eating certain foods and doing certain exercises does to it. A week ago I switched from doing a fast walk on a treadmill using some incline to walking outside. I do about 4 miles and the middle 1/3 of it I'm walking a 7yr old very sweet but very fat Labrador Retriever. She slows me down a bit but I still manage to average 19 minute miles. Without her I can do 17-18 minute miles. I've noticed on my Apple Watch my heart rate is about 20 less than when I did the treadmill. 120 vs. 100. I enjoy the walking over the treadmill and I like getting my "dog fix" in (wife refuses to get a dog). Either exercise causes my glucose levels to fall off a cliff, I even have to carry a glucose tablet with me when walking just in case I get too low.

The point is you don't need to do heavy exercise to get good health benefits. My knees are in great shape and I hope to die with the same ones I was born with.

rickair7777 06-27-2021 03:21 PM


Originally Posted by WhisperJet (Post 3253969)
Running, for as good as they say it is has, has destroyed my back, hips, knees, etc. I now walk (10,000 steps / 5 miles a day total) and I've never felt better or been healthier. Also ditched the heavy workouts and focus on core exercises and body weight (chinups and pullups). No need to squat 350 anymore/


Originally Posted by AirBear (Post 3255543)
The point is you don't need to do heavy exercise to get good health benefits. My knees are in great shape and I hope to die with the same ones I was born with.

Current thinking is actually that impact exercise is good for your joints and cartilage, and my experience bears that out... lifelong runner, and all in good shape post age 50 (ie can still run and downhill ski). Also held up to some tactical ground-pounder abuse in the mil, including parachuting.

Running is a natural repetitive motion which we're designed for. Sports like tennis and hoops (to say nothing of football, soccer, skiing) are more likely to injure joints. If your joints are in good shape and aligned right, running will probably help maintain them. Start easy of course, and moderation appropriate to your age.

AirBear 06-30-2021 03:14 PM

Actually that makes sense because our ancestors who hunted had to do a lot of running. If their knees went out there wasn't an Ortho Doc around to fix them.
You would think walking on a treadmill and walking around the neighborhood would use the same muscles but when I switched to the latter over a week ago I could tell the difference. Also there's the heat. Treadmill I'm in an air conditioned room with 2 fans blowing on me with only underwear on. Walking outside I found out that a somewhat overweight man in his 60's with only underwear wasn't a good option :eek:


Originally Posted by rickair7777 (Post 3255640)
Current thinking is actually that impact exercise is good for your joints and cartilage, and my experience bears that out... lifelong runner, and all in good shape post age 50 (ie can still run and downhill ski). Also held up to some tactical ground-pounder abuse in the mil, including parachuting.

Running is a natural repetitive motion which we're designed for. Sports like tennis and hoops (to say nothing of football, soccer, skiing) are more likely to injure joints. If your joints are in good shape and aligned right, running will probably help maintain them. Start easy of course, and moderation appropriate to your age.



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