Does High Altitude Trigger Atrial Fibrillation (A-fib)?
For most people in Denver or along the Front Range, venturing into the High Country for hiking, camping, and skiing is a routine recreational activity. However, you probably notice that your heart works harder, and you might worry that exercising in these higher elevations might put your heart at risk. When your heart is pumping hard, you notice the beats more prominently, and you might wonder if you’re noticing that the beats are a little erratic. Are you developing heart arrhythmia, such as atrial fibrillation (A-fib)?
A-fib is the most common heart arrhythmia. Although it can increase your risk of serious cardiovascular complications, including stroke, it is manageable, with A-fib treatments available to reduce the risk of complications. There is also no good evidence that suggests going to high altitude will trigger A-fib. However, there is evidence that traveling to high altitude can exacerbate an underlying heart condition, including A-fib. As a result, many people may first become aware of A-fib during a trip to high altitude.
Does Your Heart Beat Harder at High Altitude?
Going to high altitude can challenge your body’s ability to take in enough oxygen to support healthy function. That’s because the reduced air pressure means that there is less oxygen in the air. This means that the same lungful of air does not have as much oxygen, so there’s less oxygen for the blood to absorb.
Initially, the body deals with this lower oxygen concentration by stimulating the heart to beat faster. This drives more blood, so the amount of oxygen delivered to the body, including the brain, remains constant. This state may continue for several days, but the body adapts to the low oxygen environment through hemoconcentration: removing fluid from the blood to increase the proportion of red blood cells in the same volume of blood. This allows your heart rate to return to more normal levels.
However, during the initial adaptation phase, your heart can suffer, with potentially serious consequences.
High Altitude Can Trigger A-fib
When your heart is beating harder, stress can cause your heart to beat erratically. Under normal conditions, your heart may beat essentially normally. However, when put under the stress of beating harder and faster, arrhythmias like A-fib may come out. The arrhythmias may persist when returning to low altitude, or they may resolve spontaneously.
However, this is not always the case. People with managed A-fib have different responses to high altitude, with some experiencing it as a trigger, while others finding it does not significantly impact their heart rhythm.
Many people report feeling heart palpitations when they exercise at high altitude because their heart is working much harder than expected. Whether these palpitations are indicative of arrhythmias is hard to say without definitive testing.
For people living at high altitude, there doesn’t seem to be any increased risk of A-fib.
Dangers of Exercise at High Altitude
When you initially go to high altitude, your hard-working heart may suffer badly. The increased work of the heart can exacerbate heart conditions that are otherwise controlled or benign. The American Heart Association (AHA) warns that people with heart conditions (including those with undiagnosed or managed heart conditions) may experience serious complications when they attempt to exercise at high altitude, including sudden cardiac death.
When going to high altitude, the AHA recommends that people spend at least one night at a moderate high altitude (at least ~3,400 feet above sea level) to adapt to the conditions.
Similar recommendations might be considered for people from Denver and other Front Range communities at low altitude (less than 6,550 feet in elevation) who are planning to summit a 14er. Although these are not extreme altitude, they push the envelope of high-altitude activity, so spending a night at high altitude (9,840 feet in elevation) might be beneficial if you have concerns about your heart under these conditions.
Help Managing Arrhythmias at Any Altitude
If you experience heart palpitations as a result of exercise at high altitude, you should consider getting tested to determine whether these palpitations are indicative of A-fib or another arrhythmia. In some cases, your body’s high-altitude response may be indicative of underlying conditions that may worsen if left untreated.
At South Denver Cardiology Associates, we have a dedicated Arrhythmia Clinic to help patients control arrhythmias and their symptoms. Our goal is to help you avoid troubling symptoms that interfere with your daily life. We also want to detect dangerous developments and manage them before they lead to hospitalization.
The result is not only a better quality of life for you and your family, but also significant cost savings. It is less expensive to manage an arrhythmic heart than it is to deal with complications like heart failure or stroke.
To learn how our Arrhythmia Clinic can help you manage A-fib and other heart arrhythmias, please schedule an appointment at our office in Littleton, Englewood, Denver, Parker, or Castle Rock.
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As with any health concerns, your specific treatment program should be discussed thoroughly with your primary care physician as well as any specialists who may need to be consulted – like a cardiologist.
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