Management of atrial fibrillation in German military aircrew
Abstract Introduction Arrhythmias are one of the most common causes of loss of flying privileges for both military and civilian pilots in the Western World, and atrial fibrillation (AF) is one of the most common arrhythmias worldwide. Aircrew, and particularly pilots, are subject to a unique and exa...
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | Journal of Occupational Medicine and Toxicology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12995-023-00383-5 |
| _version_ | 1797769311225380864 |
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| author | Norbert Guettler Stefan Sammito |
| author_facet | Norbert Guettler Stefan Sammito |
| author_sort | Norbert Guettler |
| collection | DOAJ |
| description | Abstract Introduction Arrhythmias are one of the most common causes of loss of flying privileges for both military and civilian pilots in the Western World, and atrial fibrillation (AF) is one of the most common arrhythmias worldwide. Aircrew, and particularly pilots, are subject to a unique and exacting working environment, especially in high-performance military aircraft. This manuscript analyzes AF cases in German military aircrew from both a clinical and occupational perspective to point out specific characteristics in this comparatively young, highly selected, and closely monitored group, and to discuss AF management with the aim of a return to flying duties. Methods The digital information systems of the German Air Force Centre of Aerospace Medicine (GAFCAM) were searched for aircrew (pilot and non-pilot aircrew from German Air Force, Army, and Navy) with the diagnosis of AF. Evaluation results for underlying disease, AF characteristics, important clinical findings, and occupational decisions were analyzed in the light of current clinical guidelines and aeromedical regulations. Results In a 34-year period, between March 1989 and January 2023, 42 aircrew with at least one episode of AF were registered, all of them were male. The median age at initial diagnosis was 47 years (min 22 years, max 62 years). The median follow-up period was 5.35 years. 19 of them (45%) were pilots. The breakdown of events and occurrence was found to be: single (23), paroxysmal (16), persistent (2), permanent (1). In 27 aircrew (64%) AF terminated spontaneously. Long-term recurrence prevention was variable with catheter ablations in 8 cases. 36/42 aircrew were returned to flight status with restrictions, while 6/42 were permanently disqualified from flying. Conclusion Management of AF in military aircrew requires a comprehensive approach regarding the flight environment as well as clinical guidance. Aeromedical disposition should be case-by-case based on aeromedical regulations, individual clinical findings, and specific occupational requirements in this challenging field of work. |
| first_indexed | 2024-03-12T21:06:06Z |
| format | Article |
| id | doaj.art-7d03f8d067164ad2970e8016da3eb039 |
| institution | Directory Open Access Journal |
| issn | 1745-6673 |
| language | English |
| last_indexed | 2024-03-12T21:06:06Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Occupational Medicine and Toxicology |
| spelling | doaj.art-7d03f8d067164ad2970e8016da3eb0392023-07-30T11:27:33ZengBMCJournal of Occupational Medicine and Toxicology1745-66732023-07-011811710.1186/s12995-023-00383-5Management of atrial fibrillation in German military aircrewNorbert Guettler0Stefan Sammito1German Air Force Centre of Aerospace MedicineGerman Air Force Centre of Aerospace MedicineAbstract Introduction Arrhythmias are one of the most common causes of loss of flying privileges for both military and civilian pilots in the Western World, and atrial fibrillation (AF) is one of the most common arrhythmias worldwide. Aircrew, and particularly pilots, are subject to a unique and exacting working environment, especially in high-performance military aircraft. This manuscript analyzes AF cases in German military aircrew from both a clinical and occupational perspective to point out specific characteristics in this comparatively young, highly selected, and closely monitored group, and to discuss AF management with the aim of a return to flying duties. Methods The digital information systems of the German Air Force Centre of Aerospace Medicine (GAFCAM) were searched for aircrew (pilot and non-pilot aircrew from German Air Force, Army, and Navy) with the diagnosis of AF. Evaluation results for underlying disease, AF characteristics, important clinical findings, and occupational decisions were analyzed in the light of current clinical guidelines and aeromedical regulations. Results In a 34-year period, between March 1989 and January 2023, 42 aircrew with at least one episode of AF were registered, all of them were male. The median age at initial diagnosis was 47 years (min 22 years, max 62 years). The median follow-up period was 5.35 years. 19 of them (45%) were pilots. The breakdown of events and occurrence was found to be: single (23), paroxysmal (16), persistent (2), permanent (1). In 27 aircrew (64%) AF terminated spontaneously. Long-term recurrence prevention was variable with catheter ablations in 8 cases. 36/42 aircrew were returned to flight status with restrictions, while 6/42 were permanently disqualified from flying. Conclusion Management of AF in military aircrew requires a comprehensive approach regarding the flight environment as well as clinical guidance. Aeromedical disposition should be case-by-case based on aeromedical regulations, individual clinical findings, and specific occupational requirements in this challenging field of work.https://doi.org/10.1186/s12995-023-00383-5Atrial fibrillationAircrewMilitaryAviationAerospace medicine |
| spellingShingle | Norbert Guettler Stefan Sammito Management of atrial fibrillation in German military aircrew Journal of Occupational Medicine and Toxicology Atrial fibrillation Aircrew Military Aviation Aerospace medicine |
| title | Management of atrial fibrillation in German military aircrew |
| title_full | Management of atrial fibrillation in German military aircrew |
| title_fullStr | Management of atrial fibrillation in German military aircrew |
| title_full_unstemmed | Management of atrial fibrillation in German military aircrew |
| title_short | Management of atrial fibrillation in German military aircrew |
| title_sort | management of atrial fibrillation in german military aircrew |
| topic | Atrial fibrillation Aircrew Military Aviation Aerospace medicine |
| url | https://doi.org/10.1186/s12995-023-00383-5 |
| work_keys_str_mv | AT norbertguettler managementofatrialfibrillationingermanmilitaryaircrew AT stefansammito managementofatrialfibrillationingermanmilitaryaircrew |