Visiting High Altitudes Is Possible

We wish to make an additional comment with regard to treatment with implantable cardioverter defibrillators (ICDs). The summary in the Box suggests that patients with ICDs should categorically be advised not to travel to altitudes higher than 2000 meters. This means that, in addition to physical activity in the mountains, such patients should also be advised against air travel, since cabin pressure is usually similar to that of outside pressure at an altitude of 1500–2500 meters.

A low rate of arrhythmias at altitudes higher than 2000 meters (even without acclimatization) does not support the idea of a substantial risk of arrhythmias in patients with ICDs (1). Assessment of a patient’s altitude fitness is therefore based primarily on the patient’s underlying disease, which often limits what patients should be advised to do. The presence of an ICD alone should, however, not constitute a reason not to travel to high altitudes.

DOI: 10.3238/arztebl.2012.0445a

Haitham Badran, MD, PhD

Deutsches Herzzentrum München

Ain Shams Universität, Kairo

PD Dr. med. Christof Kolb

Deutsches Herzzentrum München

kolb@dhm.mhn.de

Conflict of interest statement

Haitham Badran receives a scholarship from the European Heart Rhythm Organisation (EHRA). Dr Christof Kolb has received honoraria for speaking or acting as an adviser from Biotronik, Boston Scientific, Medtronic, St Jude Medical, and Sorin, and has conducted research projects that were funded by Biotronik, Medtronic, St. Jude Medical, Sorin, and Stereotaxis.