Heart Rhythm Conditions – Welcome to the group

Hi. My name is Doug. I'm 70 years of age and was diagnosed with AFib a year ago. I'm on Eliquis, Bisoprolol and Flecainide and these seem to control my condition very well. I am usually very active although not much in the past year to to hip problems, but after a hip replacement 4 months ago I am just getting back on my feet. I'm hoping to do another multi week trekking trip in Nepal which would include altitudes up to 5,000 metres (16,000 feet). My last Nepal trip was in 2019 and I handled the heavy exertion and altitude quite well after training hard, but that was pre-Afib. However the new meds have slowed my heart rate considerably and I'm not sure how realistic this is. I'm thinking with my "pump" running at a lower speed it could be pretty difficult doing this sort of trip again. Would welcome any thoughts from others.

Honestly? Can you take up hiking at sea level altitudes?! Do you have tachycardia or shortness of breath or chest pain with your afib? Is it continuous?

I do hike at sea level too but it doesn't hold a candle to the Himalayas. I actually don't know if I have tachycardia but I don't have any chest pain and so far no shortness of breath. My Afib seems to be well controlled with my meds so far and the only time I notice it is if I have a bit of alcohol.

The Nepal trip sounds like a lot to take on with Afib, medications, and a recent hip replacement. I would suggest that you use a device (e.g., Apple Watch) that monitors your heart rate, detects Afib, oxygen levels, etc. so that you know what is going on when you are training. And of course, get clearance from your cardiologist. In the past, I had a lot of difficulty running when I was put on a beta blocker for PVCs. What would concern me more is that you may not be within reach of medical care if you have a problem when you are trekking in Nepal.

Thanks for this. Funny you should mention a device for monitoring those things - I literally was looking into those when your message arrived, for the exact reasons you stated.
Not worried at all about the hip - it's doing well. I had a knee replacement some years back and have done 2 Nepal trips with it without a problem so am confident I can assess its readiness by next October.
My cardiologist tends to give me about 5 minutes of his time and just doesn't seem to understand that not everyone wants to live a sedentary lifestyle. When I saw him for hip surgery clearance and mentioned a future trekking trip he said I should take up swimming instead because of the hip and didn't even mention my heart! I really would like to find a cardiologist who has experience with this type of activity.
You make an excellent point about remoteness, but that is a factor for everyone doing these trips - there is always the risk of a problem (altitude sickness, injury, etc) and turning back or even helicopter rescues are quite common. I guess my risk would be somewhat higher due to AFib. From what I've read I might need a slower schedule in order to acclimatize going up; we are always very particular about that but would need to be even more so.
Sorry but I'm not familiar with PVC.

Hello @otiswinston and welcome to the group. Good idea for reaching out to this site, you'll get a lot of good feedback.
I, too, have afib, having been diagnosed quite a few years ago. And have had hypertension for over 30 years. I've been on Verapamil for years and various BP meds, then just started Xarelto a few months ago. I've lived in a city for over 30 years that's at 5000' (Denver is not the only "Mile High City"). We're close to CO so have gone up there frequently. I've never had breathing problems or increased problems with afib until last summer. (I was at 7000'). I was short of breath and my feet and legs swelled significantly. I was 73 and worked out pretty consistently. It was disconcerting.
So, will you be trying a long hike at a higher elevation in the US prior to committing to Nepal?
I totally understand the frustration that comes with having to make changes in your life as you get older and have more health problems, but regardless of other's opinions, only you can decide how you're going to handle those changes. Best of luck in making this decision.

God love you! You rock, Sir; bless your heart.

Thank you for your reply. I don't really have an opportunity to try higher elevations before going to Nepal. With my new hip working well I am now starting to test my heart's reaction to more vigorous exercise (at lower elevations where I live). From the readings I've done it would seem I would need longer time than my previous "normal" to acclimatize as I go higher, and monitor my self even more closely for signs of problems. I've always been careful about following the recommended methods for acclimatizing - staying well hydrated, taking Diamox above certain elevations, taking acclimatization days (with hikes where we walk high and sleep low), etc. I would really like to contact a cardiologist who has experience with high altitudes as unfortunately I don't have much faith in my current one.

If it were me, I would not go. If you require meds to keep your rate controlled, and if you need anti-arrhythmic medication to control fibrillation, PACs, PVCs, etc, you are inviting a lot of potential advancement of your disease by incurring more stress. Your heart will be stressed. Your organs will be stressed.

Remember that it is a progressive disease. Piling inordinate demands on your system while you harbor a progressive disorder is not something I would feel comfortable doing. I would worry about kicking the disorder up another riser and have the AF needing even more medication, or a different one if that one works better. The problem with AF is that it progresses, including eventually being immune to whatever meds you're currently prescribed. You want to slow the progression....or I would, at least.

I agree with the advice to do as your conscience can handle. Just be aware that you might rue your hubris, and have fewer options except a catheter ablation, resorting to amiodarone, or worse, eventually needing a pacemaker and have the AV node ablated.

@otiswinston, I would have to agree with those in this group that are encouraging you not to go to Nepal. Of course, in the end, only you can decide.
Would there be an alternative in the States? No, we have nothing that high or probably as beautiful as Nepal, but there are plenty of hikers in this country and plenty of mountains to climb. Telluride Co is over 12,000', is a beautiful area with lots of hikers, climbers, mountain bikers, etc. I would guess there are doctors there that deal with those types of people and are very familiar with the effects of the altitude.
Maybe there's something else you could really enjoy where you wouldn't be taking as much of a risk to you health.
Again, only you can decide.