FAA Aerospace Medical DispositionsCardiac Rhythm IssuesArrhythmias, Blocks, Dysrhythmias
|
|
Guide for Aviation Medical Examiners
Decision Considerations
Aerospace Medical Dispositions
Item 36. Heart - Atrial Fibrillation
| Disease/Condition | Class | Evaluation Data | Disposition | History of Atrial Fibrillation > 5 years ago | All | Document previous workup for CHD and structural heart disease | If no ischemia, no history of emboli, no structural or functional heart disease - Issue Otherwise - Requires FAA Decision |
|---|---|---|---|
| Chronic | All | CHD Protocol with ECHO and 24-hour Holter | Requires FAA Decision |
| Paroxysmal/Lone | All | CHD Protocol with ECHO and 24-hour Holter | Initial Special Issuance - Requires FAA Decision Followup Special Issuances - See AASI Protocol |
| Disease/Condition | Class | Evaluation Data | Disposition |
|---|---|---|---|
| Bradycardia ( < 50 bpm) | All | Document history and findings, CVE Protocol, and submit any tests deemed appropriate | If no evidence of structural, functional or coronary heart disease - Issue Otherwise - Requires FAA Decision |
| Bundle Branch Block (Left and Right) | All | CVE and GXT Protocols See GXT BBB Requirements |
If no evidence of structural, functional or coronary heart disease - Issue Otherwise - Requires FAA Decision |
| History of Implanted Pacemakers | All | See Implanted Pacemaker Protocol | Requires FAA Decision |
| PAC (2 or more on ECG) | All | Requires evaluation, e.g., check for MVP, caffeine, pulmonary disease, thyroid, etc. | If no evidence of structural, functional or coronary heart disease - Issue Otherwise - Requires FAA Decision |
| PVC's (2 or more on standard ECG) | All | Max GXT to include a baseline ECG | If no evidence of structural, functional or coronary heart disease and PVCs resolve with exercise - Issue Otherwise - Requires FAA Decision |
| 1st Degree AV Block | All | Document history and findings, CVE Protocol, and submit any tests deemed appropriate | If no evidence of structural, functional or coronary heart disease - Issue Otherwise - Requires FAA Decision |
| 2nd Degree AV Block Mobitz I |
All | Document history and findings, CVE Protocol, and submit any tests deemed appropriate | If no evidence of structural, functional or coronary heart disease - Issue Otherwise - Requires FAA Decision |
| 2nd Degree AV Block Mobitz II |
All | CVE Protocol in accordance w/ Hypertensive Evaluation Specifications and 24-hour Holter | Requires FAA Decision |
| 3rd Degree AV Block | All | CVE Protocol in accordance w/ Hypertensive Evaluation Specifications and 24-hour Holter | Requires FAA Decision |
| Preexcitation | All | CVE Protocol, GXT, and 24-hour Holter | Requires FAA Decision |
| Radio Frequency Ablation | All | 3-month wait, then 24-hour Holter | If Holter negative for arrhythmia, no recurrence - Issue Certificate Otherwise - Requires FAA Decision |
| Supraventricular Tachycardia | All | CHD Protocol with ECHO and 24-hour Holter | Initial Special Issuance - Requires FAA Decision Followup Special Issuances - See AASI Protocol |
| Syncope * | All | CHD Protocol with ECHO and 24-hour Holter; bilat-carotid US | Requires FAA Decision |
Note: Syncope (fainting), not satisfactorily explained or recurrent requires deferral (even though the syncope episode may be medically explained, an aeromedical certification decision may still be precluded). Syncope may involve cardiovascular, neurological, and psychiatric factors. AMEs will not immediately issue medical certificates if there are heart conditions that require deferral, or for any other cardiac condition that may result in sudden or subtle incapacitation. If the airman has one of these conditions, then the AME will consult with the FAA (AMCD) or the Regional Flight Surgeon. Medical documentation must be submitted for any of these cardiac conditions to support a possible waiver (special issuance) of an airman medical certificate.
