Travel

Can you travel anywhere?

Having an ICD implanted makes no difference to whether you can travel or not. What really determines the answer is “what is the general state of your health” & “what is the risk to you if you find yourself stranded in a location with no emergency cardiac cover”? Some patients with ICDs will have no problems from either of these two questions. Other patients will have to exercise more caution regarding the locations that they intend to visit & how long they will stay there.

There are two aspects that influence recommendation to allow travel abroad. The first is the ICD & stability of the heart rhythm. If your most recent ICD check has been satisfactory & you haven’t had problems with heart rhythms for the last two months then it is OK to travel. The second is the condition that required the ICD to be implanted. Patients with ICDs often have decreased cardiac performance due to previous heart attack, valve problems or cardiomyopathy. If you get breathless with minimal activity then assistance at travel hubs will be required & long haul travel is not recommended. If you get breathless on moderate activity, long haul travel should be planned carefully to avoid strenuous activity. If you are symptom-free then most travel can be undertaken but be sensible about extreme exertion.

ICD patients normally have an appointment with their ICD Pacing Clinic every six months. However, some ICDs are compatible with wireless “remote monitoring” devices. This technique enables the patient’s ICD Pacing Clinic to monitor items such as battery, leads &/or heart rhythm whilst the patient is at home. If any problem is found, the ICD Pacing Clinic will be notified & they will get in touch with the patient. If you are interested in having such a device, please contact your ICD Pacing Clinic so that they can ascertain whether your ICD is capable of being able to perform this action &/or if this service is available to you. If you already have one of these devices, it is up to you whether or not you take it with you abroad. Things to consider are the duration of your holiday, the ease at which your monitor downloads [is it a simple plug in to the wall or is it attached via a phone line?], & how comfortable you are with having the monitor with you on a relaxing holiday.

How do I obtain holiday insurance?

As with all medical conditions, insurance may be a problem for patients with an ICD. We cannot recommend any particular company, but the following insurance companies are known to have either insured one of our ICD patients or taken a more understanding of “heart related problems”.

Staysure Co Ltd [0844-6928444]
www.staysure.co.uk/medical
They specialise in the over 50 years old group.

Insure for All [0800-0821271]
www.insureforall.com
They specialise in the over 50 years old group.

AllClear Insurance Services Ltd [0845-250-5350 or 5222]
www.allcleartravel.co.uk
Specialise in over 50 years old group, especially “cruising”.

Some insurance companies require written confirmation either from your Cardiologist or ICD Pacing Clinic to confirm that you are fit to travel & comply with their stated conditions. These requirements vary from company to company & most patients experience no difficulties. If an insurance company tries to load your policy to an unacceptable level or states unrealistic conditions, it is best to reject it & approach another insurance company.

If you are flying, some airlines may want a certificate of fitness before they will allow you to travel with them. When you are booking your flight, please make this a priority question. If one is needed, you must contact your Cardiologist for advice. At the same time, a patient should also determine if they would need oxygen during the flight. This advice should be sought from either your GP &/or Cardiologist.

What do you need to take with you on holiday?

Regardless of where you are travelling, it is imperative that you have your ICD identification card & any emergency documentation [such as a full list of all your drugs & doses] with you at all times. The ICD identification card [issued by your ICD Pacing Clinic] should always be shown to the airline security staff so that they do not insist that you must go through the metal detector. Always insist that you are escorted around the “detector”. If, usually at a foreign airport, they are adamant that you must pass through the “detector”, just quickly walk through. It is more likely that you will trigger the alarm than cause any problems to your ICD.

If you need vaccinations, inoculations or preventative medicine for the countries that you are going to visit, please check with your GP &/or ICD Pacing Clinic in case there are any possible clashes with the drugs that you are already taking. Particular care must be taken by the patient if they intend to use anti-malarial or cardiac anti-arrhythmic drugs.

"If you have been given a magnet, remember to take it with you.

Do not forget the suntan lotion & a hat, especially if you are taking Amiodarone".

Emergences.

If you do find yourself with any ICD related problem whilst you are on holiday, the best thing that you could do is to assess the situation as if you were still at home in the UK. If you feel well enough to return home, try to get your travel arrangements brought forward. If this is not possible, use your ICD passport & associated medical documents when presenting yourself at the local holiday GP &/or hospital. Lists of local hospitals in other countries that have the ability to follow up problems with an ICD are available on the internet at http://www.medtronic.com/traveling/ Patients can also ask their own ICD Pacing Clinic in the UK to obtain similar information. Please remember to give plenty of advanced notice to your ICD Pacing Clinic if this is needed.

Most Western countries such as USA, Canada, Australia, New Zealand & other countries with advanced technology within Europe will have such ICD centres. Many of the third world countries do not yet have the necessary expertise, so please check if they do have it well before you depart on your holiday.

"PLEASE NOTE THAT WE CANNOT GUARANTEE THE QUALITY OF CARE IN ANY ICD PACING CLINIC WHICH IS LOCATED IN A FOREIGN COUNTRY. WE CAN ONLY GIVE YOU A CONTACT IN CASE OF EMERGENCIES OR MEDICAL PROBLEMS THAT YOU INCUR WHILST YOU ARE ON HOLIDAY".