8. Flying: Cardiovascular Conditions

Angina Pectoris

• NYHA functional class I & II
  No restriction.
• NYHA functional class III
  Suplemental oxygen required.
• NYHA functional class IV
  Only if medically necessary and accompanied*.

* Accompanied by physician with attached ECG monitor/defibrillator, oxygen and appropriate medication.

Post-MI

• NYHA functional class I
  1-2 weeks for repatriation if uncomplicated and succesfully revascularized or low risk on angiography/non-invasive studies.
  6-8 weeks for elective travel.
• NYHA functional class II-IV
  Only if medically necessary and accompanied*.

* Accompanied by physician with attached ECG monitor/defibrillator, oxygen and appropriate medication.

Heart Failure

• NYHA functional class I & II
  Unrestricted.
• NYHA functional class III
  Suplemental oxygen required.

Valvular Disease

• NYHA functional class I & II
  Unrestricted. Supplemental oxygen suggested if pulmonary hypertension is present.
• NYHA functional class III
  Suplemental oxygen required.
• NYHA functional class IV
  Only if medically necessary and accompanied*.

* Accompanied by physician with attached ECG monitor/defibrillator, oxygen and appropriate medication.

Congenital Heart Disease

• NYHA functional class I & II
  Unrestricted. Supplemental oxygen if partial pressure of atrial oxygen <70 mmHg.
• NYHA functional class III
  Suplemental oxygen required.
• NYHA functional class IV
  Only if medically necessary and accompanied*.

* Accompanied by physician with attached ECG monitor/defibrillator, oxygen and appropriate medication.

Post-CABG/Valve Surgery

• NYHA functional class I & II
  4 days postsurgery and hemoglobin ≥ 90 g/L if flight < 2h*.
  7 days postsurgery and hemoglobin ≥ 90 g/L if flight ≥ 2h.
  * If hemoglobin < 90 g/L and wishes to avoid transfusion, then supplemental oxygen is required.

Therapeutic Intervention – PCI/ASD Closure

• NYHA functional class I & II
  1 day postprocedure. If PCI following MI, post-MI guidelines prevail.

Arrhythmia/Post-arrhythmia Procedure

• NYHA functional class I & II
  Well-controlled supraventricular arrhythmias – unrestricted.
  1 day postprocedure for supraventricular arrhythmias.
  2 days postprocedure for ventricular arrhythmias.
• NYHA functional class III & IV
  Uncontrolled hemodynamically significant ventricular arrhythmias should not fly by commercial aircraft.

Post-pacemaker/ICD/Loop Recorder Implant

• NYHA functional class I & II
  1 day post implant if no pneumothorax, device functions normally and is programmed appropriately.

ICD Patients

• NYHA functional class I & II
  1 month following last intervention from device associated with severe presyncope/syncope.