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Atrial fibrillation in two jet pilots during aircrew periodical medical examination.
MedLine Citation:
PMID:  22779316     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Atrial fibrillation (AF) unfavorably affects cardiac output and may cause acute incapacitation in flight due to loss of the atrial systole, which mainly contributes to the diastolic filling of the ventricles. Although it is the most common type of arrhythmia, it is rare in pilots and not compatible with aviation.
CASE REPORTS: We present two AF cases incidentally detected in two jet pilots. The first case was a 39-yr-old male jet pilot with a lone AF. Since there was no structural abnormality or thrombus in the left atrial appendage on transesophageal echocardiography (TEE), the patient was converted to sinus rhythm via direct current cardioversion (DCC). The pilot returned to flying duties after a follow-up period without any recurrent arrhythmia. The second case was a 23-yr-old male jet pilot who had suffered six attacks of paroxysmal AF. Conversion to sinus rhythm was provided by DCC at once and the second via pharmacological cardioversion. Also, spontaneous conversion to sinus was observed during two attacks of AF during the follow-up period. There were no abnormalities on physical examination, echocardiography, and laboratory tests. Although the cardiac ablation procedure was applied, the patient couldn't be treated successfully. Thereafter the pilot was treated with sotalol and warfarin and was permanently disqualified from flying duties.
DISCUSSION: Arrhythmia is among the frequent causes for aviators to be disqualified from flying duties. AF particularly should not be overlooked due to its potential for sudden incapacitation during flight via acute hypotension or thromboembolic events.
Authors:
Cengiz Ozturk; Ahmet Akin; Suleyman Metin; Tolga Cakmak; Ahmet Sen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Aviation, space, and environmental medicine     Volume:  83     ISSN:  0095-6562     ISO Abbreviation:  Aviat Space Environ Med     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7501714     Medline TA:  Aviat Space Environ Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  706-10     Citation Subset:  IM; S    
Affiliation:
Department of Cardiology, Eskisehir Military Hospital, Eskisehir, Turkey.
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