Management of atrial fibrillation in German military aircrew

Journal of Occupational Medicine and Toxicology

Research

Norbert Guettler¹  Stefan Sammito² 

[1] German Air Force Centre of Aerospace Medicine, Flughafenstrasse 1, 51147, Cologne, Germany;Department of Cardiology, Justus Liebig University, University Hospital Giessen, Medical Clinic I, Giessen, Germany;German Air Force Centre of Aerospace Medicine, Flughafenstrasse 1, 51147, Cologne, Germany;Department of Occupational Medicine, Medical Faculty, Otto Von Guericke University, Magdeburg, Germany;

关键词: Atrial fibrillation;    Aircrew;    Military;    Aviation;    Aerospace medicine;   

DOI  :  10.1186/s12995-023-00383-5

 received in 2023-03-23, accepted in 2023-07-12,  发布年份 2023

来源: Springer

【 摘 要 】

IntroductionArrhythmias 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.MethodsThe 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.ResultsIn 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.ConclusionManagement 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.

【 授权许可】

CC BY   
© The Author(s) 2023