title: Prognostic and clinical significance of newly acquired complete right bundle branch block in Japan Airline pilots.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the prognostic and clinical significance of newly acquired complete right bundle branch block (CRBBB) in airline pilots.
  
  
  METHODS
  This study included pilots with acquired CRBBB, identified from a group of over 2,700 Japan Airline pilots. When the pilots applied for employment, a past medical history, physical examination, electrocardiogram, and chest radiograph were obtained. The pilots with ECG abnormality including CRBBB were not included in the study because of hiring requirements.
  
  
  RESULTS
  Thirty-six pilots with CRBBB were identified between 1983 and 2002. All pilots with CRBBB were evaluated for the presence of ischemic heart disease by treadmill exercise testing, echocardiogram and exercise thallium scintigraphy. Twelve individuals underwent coronary angiography. The mean age of pilots was 44.4 +/- 5.8 years. The mean observation period was 10.9 +/- 5.7 years. For each of the 36 study subjects, Holter electrocardiogram and echocardiogram were obtained every 6 months after the CRBBB was detected. Exercise stress testing was performed every year. Exercise thallium scintigraphy was performed every 2 years to detect ischemic heart disease. During the observation period, two pilots stopped flying temporarily because of frequent ventricular premature beats and one pilot stopped flying permanentaly because of atrial fibrillation. During the follow-up period, no cardiovascular events were observed in pilots with CRBBB who had no underlying ischemic heart disease.
  
  
  CONCLUSIONS
  Acquired CRBBB does not confer a poor prognosis, particularly in young men working as a pilot if there is no evidence of ischemia on exercise stress testing, echocardiography and exercise thallium scintigraphy.
authors.affiliation: Flight Crew Medical Service Department, Japan Airline, 3-6-8 Haneda-kuko, Ohta-ku, Tokyo 144-0041.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Taniguchi
authors.forename: Hajime
authors.initials: H
authors.lastname: Nakano
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kuwahara
authors.forename: Izuru
authors.initials: I
authors.lastname: Masuda
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Okawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Miyazaki
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Okoshi
authors.forename: Masanobu
authors.initials: M
authors.lastname: Kaji
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Noguchi
authors.forename: Ichiro
authors.initials: I
authors.lastname: Asukata
mesh_terms: D000328:Adult; D000337:Aerospace Medicine; D000401:Aircraft; D002037:Bundle-Branch Block / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors