Flying With a Pacemaker Domestically and Overseas

When my husband got his pacemaker in 2016, we wondered if air travel would ever feel simple again. The good news? It absolutely can! Over the years, we’ve learned a lot about navigating airport security, long flights, and everything in between.

In this guide, I’ll share the tips we’ve picked up from our own travels—along with some helpful insights straight from the TSA. Whether it’s your first time flying with a pacemaker or you’re just looking for a smoother journey, we’ve got you covered.

We do a deep dive into domestic and internation air travel with medical equipment in our guide to Flying with Medical Devices. For now, let me prepare you for a stress-free trip with your pacemaker.

1. Navigating TSA Security with a Pacemaker

1.1 What to Expect at TSA Checkpoints

Flying with a pacemaker requires a bit of planning, as do CPAPs and nebulizers, but airport security doesn’t have to be a hassle if you know what to expect. Here’s how to prepare:

• Inform TSA agents immediately that you have a pacemaker before screening begins.
  • You can do this by verbally telling the agent before stepping into the screening area. Some travelers also choose to carry a small medical alert badge for additional clarity.
• Show Your TSA Notification Card: TSA has an easy-to-print card that individuals with disabilities and medical conditions can present. Just fill in pacemaker or whatever device or medical condition you have.
• Opt for a manual pat-down or a handheld scanner, which TSA agents are trained to use on pacemaker patients.
  • The manual screening is a hands-on process where a TSA officer will check for any concealed items while avoiding direct pressure on the pacemaker area.
• Carry your pacemaker ID card, though it’s rarely required.
  • While TSA doesn’t mandate carrying a pacemaker card, it can help explain your medical condition in case of questions. Some travelers also store a digital copy on their phone for easy access.

KEEN TIP: TSA’s official guidance states that travelers with pacemakers can request alternative screening methods. If an agent doesn’t comply with your request, politely ask for a supervisor.

1.2 International Airport Security Considerations

Security procedures abroad may vary, but the general process is similar:

• Language Barriers: Carry a translated pacemaker ID card if traveling to a non-English-speaking country. Some medical device manufacturers provide multi-language versions.
  • If you’re traveling to a country where English is not widely spoken, having a translated pacemaker card can expedite security checks and prevent misunderstandings.
• Screening Differences: Some countries may still insist on using full-body scanners. Stand firm in requesting a manual screening if needed.
  • Unlike the U.S., certain international airports may not be as familiar with alternative screening protocols. Be prepared to explain your situation and get a supervisor if necessary. During screening for our return flight from Nice to Zurich, the agent did not understand that my husband could not use a scanner. I had shown him a translation in French on index cards that said “My husband has a pacemaker. He cannot go through a scanner.” (While I do speak some French, this was not a time for silly errors.) He still motioned my husband through the scanner, so I pulled out my index card that said “May we please see a supervisor?” In moments, the supervisor arrived, spoke at length to the agent, and my husband got his typical pat down.
• Extra Screening Time: Security lines at international airports can be longer, so allow extra time for screening.
  • Many countries have additional layers of screening for international travelers, so arriving early ensures you have enough time for any unexpected delays.

KEEN TIP: Research the specific airport policies for your destination to avoid last-minute surprises. You can go on Reddit or Quora and put in that out of the way airport you’re flying into + pacemaker and learn a lot from other people’s experiences.

2. Flying with a Pacemaker-Defibrillator (ICD): What to Know

Some travelers have both a pacemaker and an implantable cardioverter-defibrillator (ICD). While the core travel procedures are the same, there are a few additional considerations when flying with an ICD.

2.1 TSA Screening and Security Procedures

• TSA follows the same screening process for ICDs as for pacemakers. Inform the TSA officer before screening begins and request a manual pat-down instead of walking through a metal detector.
• Avoid full-body scanners with electromagnetic fields. You have the right to request alternative screening.
• Carry an ICD ID card in case TSA agents need confirmation of your device. While not required, it can make the process smoother.
• Be aware of ICD shocks. If your ICD delivers a shock while in the security line, notify an agent and take a moment to recover before proceeding.

2.2 International Travel and Customs Considerations

• Customs procedures remain the same as for pacemakers. Carry a translated medical ID card if traveling to a country where English is not widely spoken.
• Security screening protocols may vary by country. Some international airports may insist on body scanners—stand firm in requesting a pat-down instead.
• Allow extra time for screening. International security can take longer, and some agents may be unfamiliar with ICDs, requiring additional explanation.

2.3 Handling an ICD Shock During Air Travel

• Notify the flight crew. If you feel unwell or experience multiple shocks, the airline can arrange for medical assistance upon landing.
• Going forward onsider travel insurance with emergency medical evacuation. While rare, it ensures you receive proper care if a significant issue arises.

3. Packing Tips for Flying with a Pacemaker

Proper packing can make your trip smoother and reduce stress at security checkpoints.

3.1 Essential Items to Bring

• Pacemaker ID Card – Useful in case of emergencies or language barriers.
  • This small card provides critical medical information and can help security or medical personnel understand your condition if needed.
• Index Cards – Get translations of key things you need to tell the agent, such as you are flying with a pacemaker and are requesting a pat down rather than a scanner and have them on index cards you can pull out.
• Medical Documentation – Carry a doctor’s note if traveling internationally.
  • Some countries require medical documentation for certain conditions. A letter from your doctor explaining your pacemaker may help in case of questions.
• Travel Insurance Details – Ensure your policy covers pacemaker-related medical emergencies.
  • If you need emergency medical care related to your pacemaker, having a comprehensive travel insurance policy can save thousands of dollars in medical expenses.
• Medication Storage – If you take heart-related medications, keep them in their original packaging in your carry-on.
  • TSA does not require that medications be in their original prescription bottles to pass through security, but if you are flying internationally, keep all meds in original bottles. Always carry enough medication for your entire trip, plus a few extra days’ worth in case of delays.

3.2 Avoiding Electromagnetic Interference

Although rare, some airport electronics and security equipment can interfere with pacemakers. To minimize risk:

• Keep distance from strong electromagnetic sources, like power lines and industrial security scanners.
  • Avoid standing too close to large electronic security machines, such as baggage scanners.
• Avoid placing electronic devices directly over your chest (e.g., smartphones, noise-canceling headphones).
  • While modern pacemakers are well-shielded, some devices emit electromagnetic signals that could interfere with functionality when placed directly over the chest area.

4. Managing Long Flights with a Pacemaker

Long-haul travel can present unique challenges, but small adjustments can improve comfort and safety.

4.1 Staying Comfortable on Board

• Move regularly – Get up and walk every couple of hours to prevent circulation issues.
  • Sitting for extended periods increases the risk of blood clots. Stretching your legs and taking short walks can help.
• Stay hydrated – Dehydration can impact heart health, so drink plenty of water.
  • The low humidity in airplane cabins can lead to quicker dehydration. Avoid excessive caffeine or alcohol, which can contribute to fluid loss.
• Wear compression socks – These can help prevent swelling and reduce the risk of deep vein thrombosis (DVT).
  • Compression socks improve circulation, reducing the likelihood of leg swelling during long flights.
• Bring noise-canceling headphones – They are safe to use with a pacemaker and help reduce travel fatigue.
  • Loud airplane noise can be tiring. Noise-canceling headphones make the journey more comfortable.

4.2 Jet Lag and Pacemaker Patients

Time zone changes can affect energy levels and sleep patterns. This is not a problem for my husband, who has a tough time sleeping to begin with, but our travel doctor gave us some tips I will pass along. To adjust smoothly:

• Sync your sleep schedule before departure.
  • Gradually shifting your sleep schedule before travel can help your body adjust to the new time zone.
• Expose yourself to natural light to help reset your body clock.
  • Sunlight is one of the most effective ways to regulate your circadian rhythm after travel.
• Adjust medication schedules gradually if your doctor recommends changes.
  • If you take medications at a specific time of day, consult your doctor about how to adjust for time zone changes.

5. Frequently Asked Questions (FAQ’s)

5.1 Should I notify my airline before flying with a pacemaker?

While not required, notifying your airline ahead of time can ensure they are prepared for any accommodations you may need. This is entirely up to you. If you feel more comfortable alerting your airline, I would recommend downloading their app and doing it that way so they can make a record–plus, you are not on hold as you would be with a phone call.

5.2 Are there any airlines that provide special accommodations for pacemaker patients?

Most airlines do not have specific policies for pacemaker patients, but many offer assistance for passengers with medical conditions. You can request priority boarding, extra legroom, or assistance getting through security by calling the airline in advance.

5.3 Can I go through customs with a pacemaker without issues?

Yes, but customs officers in some countries may have different screening procedures than TSA. Carrying your pacemaker ID card and a doctor’s note in the local language can help avoid delays or confusion when passing through customs.

5.4 Do high-altitude flights affect pacemakers?

No, modern pacemakers are designed to function properly at high altitudes. Airplane cabins are pressurized to safe levels, ensuring that your device continues to work without interference.

5.5 What happens if I need emergency medical assistance mid-flight?

In-flight medical emergencies are rare, but knowing what to do can make all the difference. If you experience dizziness, chest pain, or any unusual symptoms, notify the flight crew immediately. Airlines are equipped with emergency medical kits; flight attendants are trained to handle medical health hemergencies and can coordinate medical support upon landing if needed. Having a travel insurance policy that covers medical evacuation can also provide peace of mind.

6. Wrap Up

Modern pacemakers are designed to function safely at high altitudes and through airport security screenings.

The key to a stress-free journey is being well-prepared, understanding your rights, and knowing how to advocate for yourself if necessary. Typically customs agents are trained to protect pacemaker-wearers from scanners, but it’s still your job to speak up if there’s an issue.

Language barriers are easily circumvented with translated doctor notes, or cards stating your pacemaker requires a pat down rather than a scanner, translated into the language of your destination. If all else fails, politely request a supervisor.

With these travel strategies in place, you can focus on enjoying your trip rather than worrying about your device.