Atrial Fibrillation at Altitude – High Elevation Hiking on the Lares Trek

We’ve just returned from a trip to Peru which included quite a bit of time at higher elevations – most notably hiking on the Lares Trail at 4600 meters (15,000 feet) above sea level. The highest thing we have around here is the conspicuous, glacier topped Mount Shasta (4,322 meters = 14,179 feet) and I’ve never even been up to the top of it. I’ve been up Mount McLoughlin (2,894 meters = 9,495 ft) sixteen times and even back when I was in sinus rhythm I would take one breath per step near the top.

Llamas Schlepping Our Gear

I have to admit I was worried prior to going on this trip.

I had no idea how the high elevation combined with my persistent atrial fibrillation would affect me. My wife Margo, who is a travel agent, arranged a terrific trip and we had a total of sixteen friends in our group. It was all bought and paid for and I was determined to go no matter what, so I didn’t even research how high elevation might effect my atrial fibrillation before leaving. That’s right – I didn’t even Google it!

I knew that our outfitter – G Adventures – had a mechanism by which people who had problems with altitude sickness could quickly return to Cusco – so I knew that I had an opportunity to bail out if need be.


We had two or three days in Cusco, Peru, which is 3,400 meters (11,200 ft) above sea level, so I was able to acclimatize. I felt no different in Cusco than I did at home in Klamath Falls, Oregon (4200 ft) and I even went for a run up to Saksaywaman (3701 meters = 12,142 ft) and it went well – although frankly, because of endless steep hills, it did involve a lot of walking!


The Lares Trek is a nice alternative to the extremely popular Inca Trail. It is shorter (only twenty-one miles) and higher elevation (4600 meters = 15,000 feet) but most importantly it was not nearly as crowded. There were sixteen in our group (plus porters and guides) and there was one other G Adventures group of ten who we would see once or twice per day – and that was it.

Ipasayqocha Pass

In contrast, the Inca Trail hikers we spoke to at Machu Picchu told us there were 200 people camped at a single, large camp outside Machu Picchu who all entered Machu Picchu before dawn on the same morning causing quite a line for the checking of tickets and passports at the small Inca Trail entrance to the site.

Machu Picchu at Sunrise

At any rate nobody in our group had serious trouble with the elevation, although everybody was gasping a bit. Margo was a little sick on the day we went up Ipasayqocha Pass but that was related to the usual traveler’s intestinal distress rather than altitude sickness. We were fortunate – the guides said that typically in a group our size they would expect three or four people to have trouble with some degree of altitude sickness.

Hiking Over the Ipasayqocha Pass

Our group was older but fit – but I have been told that being fit or being a couch potato has no bearing on predicting who will develop altitude sickness. Some people get it and others do not. Like I said we were lucky.

As for me I had the same atrial fibrillation symptoms I have at home, perhaps a little worse. I was out of breath when I started out but after several minutes I was in no distress. It takes me a while to warm up. Even in Lima, at sea level, I would huff and puff if I picked up a couple of backpacks and marched up the stairs to our room – that’s just the way it is for me now.

The first 200 meters of the Lares Trail is, I think, the toughest, because it goes up a long section of steep stairs. I was breathing so hard at first that I thought for a bit that I would be turning back – but ten minutes later I felt no different than a normal hike here in Oregon.

The porters had an extra horse in case anybody became sick during the trek they could ride that horse. Nobody rode it but during Margo’s bad day they put her daypack on the “sick horse.”

Margo’s Pack on the Extra Horse

So to sum it up my personal experience with hiking and running at significantly high elevation while in atrial fibrillation was unremarkable. Your experience may be different, of course. As far as I can tell nobody knows until they get there whether or not they will have issues with altitude sickness – so don’t get discouraged – give it a try.

Machu Picchu at Sunrise


8 thoughts on “Atrial Fibrillation at Altitude – High Elevation Hiking on the Lares Trek

  1. Those are some phenomenal photos, Moik. You know, if you had the ability, it might have been interesting to get some strips & check O2 sats at various points throughout your journey. Maybe next time, eh?

    • That would have been interesting – I should have brought a Finger Pulse Oximeter, although I don’t actually own one. A family doc that was on this Peru trip has brought one on a previous high elevation trip he did to Central Asia (a hunting trip – I wasn’t there) and everybody had decreased 02 saturation – especially the guy who was a smoker. That guy spent the entire trip in his tent only coming out to smoke.

  2. Sounds good. I’ve been planning to climb Mt Teide in Tenerife, but have been apprehensive about my PAF. It’s only a 2 day trip, hike up to a cabin at 3250m stay there for the night then hike to the summit 3718m early in the morning to catch the sunrise and then descend again. The GP’s here in the UK won’t offer advice so it’s totally down to my own decision.

    • Have a good trip. Be careful. I did fine at 15,000 feet (meters?) but remember I am in permanent a fib and am used to it. I feel sorry for someone who might “go into” a fib on a climb like that. It’d really take the wind out of your sails!

      • Thanks and will do. I can cancel the trip up to 24 hours in advance without losing my money if I don’t feel up to it. 15,000ft is nearly 4,600m so a lot higher than I’ll be going and it sounds like you were at those altitudes for a longer period of time.

  3. Interesting and inspiring, I live at about 6500 feet, and have had painful episodes of AFIB during mountain hikes. I have vagal mediated parasympathetic lone afib, and episodes have become more frequent. I’m 77. I haven’t tolerated and have discontinued meds because of low BP. I’m wondering if you are on any kind of regimen outside of regular exercise to manage your persistent AFIB, which you seem to be doing quite well.

    • I really don’t have any insight regarding treatment (I am not a cardiologist or primary care physician) – but can only report that since I started a relatively high dose of a beta blocker the wind has been taken out of my sails, so to speak, as far as climbing is concerned. When I went to Peru asymptomatic – I was lucky.

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