Afib question

A

A big fibber

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Have had PACs for awhile and cardiologist says they are benign. I had my first bout with Afib a couple days ago in the late afternoon. Went to the emergency room. They talked about a cardioversion I was willing to try drugs first and that slowed my rate to a reasonable number but I was still in Afib. They decided to keep me overnight and it converted back to normal rhythm the next morning at 7AM while having a bowel movement (Vagus nerve???) and I went home that afternoon after an echo cardiogram and a good EKG.

Not sure what started it I had been a bit sleep deprived the previous two days and under a bit more stress than usual but who knows. I am a 1 on the CHADS score due to Hypertension. I should mention the Afib was not at all debilitating I drove myself to the hospital 45 minutes away and other than a fluttery feeling I had no other symptoms. I am scheduled to meet with my cardiologist and primary care in the next week or so.

I realize under Basic Med which I am on there is no SI needed. What are some prudent steps to take? Questions I should ask my doctor? If I was under a class 3 I know what the FAA wants to see and perhaps the cardiologist will recommend some of that. As I mentioned already I had an echo cardiogram and heart function appears to be normal. In the case of Paroxysmal Afib it is not like you have any idea when it might start again or if it ever will, although obviously it is fairly likely at some point. I feel perfectly fine now and I did then other than the racing heart.

I know Afib can occur without people having symptoms but how often does that really happen? How often are Afib symptoms debilitating? I realize a stroke caused by Afib would be a real problem.

What is your experience?
 
The best person to comment is Dr. Bruce Chien, a very senior and knowledgeable AME, who is a member of PoA as @bbchien
 
Prudent steps? Maintain the relationship with your cardiologist and enjoy your life without FAA interference!
 
Well, (stewartb notwithstanding) FAA will want a stress treadmill to 9 minutes and heart rate equal to 90% of (220-(Your Age)).
24 hour holter monitor
The Echocardiogram that they did in the hospital.
Fasting Glucose and lipids
Attending Doc's summary history and physical and commentary as to your CAD risk factor management.

If you do this obtain it ALL before you say BOO to the FAA. You could go to basic, but then if/when yo re-enter (larger ship, etc) you will have to run it then, and you'll be several years older. i say, if you can do it, do the above at no FAA risk, and do it privately. 7% of new Afibs are actually coronary in origin and I would want personally to know.

If you have all of the above and the tracings are TRUE negative (non = equivocal) then apply and it's a AME calls in for permission to issue, issue the certificate kinda deal. Even if you quit the Special issuance (annually: holter + letter from the doc) you never have to run the treadmill again.

Dr B.
 
I believe the OP is presently on BasicMed. Sounds like he should take these steps in any case to know health status.
 
Well, (stewartb notwithstanding) FAA will want a stress treadmill to 9 minutes and heart rate equal to 90% of (220-(Your Age)).
24 hour holter monitor
The Echocardiogram that they did in the hospital.
Fasting Glucose and lipids
Attending Doc's summary history and physical and commentary as to your CAD risk factor management.

If you do this obtain it ALL before you say BOO to the FAA. You could go to basic, but then if/when yo re-enter (larger ship, etc) you will have to run it then, and you'll be several years older. i say, if you can do it, do the above at no FAA risk, and do it privately. 7% of new Afibs are actually coronary in origin and I would want personally to know.

If you have all of the above and the tracings are TRUE negative (non = equivocal) then apply and it's a AME calls in for permission to issue, issue the certificate kinda deal. Even if you quit the Special issuance (annually: holter + letter from the doc) you never have to run the treadmill again.

Dr B.


From the OP-
I realize under Basic Med which I am on there is no SI needed. What are some prudent steps to take?

This is a situation to celebrate the benefits of BasicMed. Let your cardiologist manage your cardiac health. Appreciate that whatever treatment path is taken is none of the FAA's business!
 
From the OP-


This is a situation to celebrate the benefits of BasicMed. Let your cardiologist manage your cardiac health. Appreciate that whatever treatment path is taken is none of the FAA's business!

I think this is hard for some people to get used to mentally when you have been under the thumb of the FAA for so long. It is almost like Battered wife syndrome. :)
 
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