title: Decadal electrocardiographic changes between age 40 and 50 in military pilots.
abstract: BACKGROUND
  Cardiovascular diseases can lead to sudden in-flight incapacitation and long-term disability in aircraft pilots. Electrocardiogram (ECG) has been widely used to screen for these diseases in routine aeromedical examinations. Several ECG changes such as complete left bundle-branch block (CLBBB) and left ventricular hypertrophy (LVH) have been associated with increased likelihood of underlying structural cardiac diseases in addition to the emergence of newly recognized cardiovascular diseases such as Brugada syndrome. Therefore, the purpose of this study was to analyze decadal ECG changes in aircraft pilots between 40 and 50 yr in order to make an appropriate evaluation of these ECG changes.
  
  
  METHODS
  We analyzed the ECGs from the annual aeromedical examination of age 50 compared to those 40 yr of age in a total of 176 Japan Air Self-Defense Force pilots.
  
  
  RESULTS
  With regard to decadal changes, we detected 34 new ECG changes (1 of sinus tachycardia, 8 sinus bradycardia, 1 atrial fibrillation, 2 premature atrial contraction, 1 premature ventricular contraction, 2 left axis deviation, 6 first-degree atrioventricular block, 1 CLBBB, 3 complete right bundle-branch block, 2 incomplete right bundle-branch block, 1 right ventricular conduction delay, and 6 LVH). Although the majority of them were concluded to be normal variants, the results of echocardiography in two hypertensive pilots without good control demonstrated abnormalities: one had mild hypertrophic nonobstructive cardiomyopathy and another had heart enlargement.
  
  
  CONCLUSIONS
  Thus, this study recommends additional cardiovascular examinations, including echocardiography for hypertensive pilots with ECG changes.
authors: Aeromedical Laboratory, Japan Air Self-Defense Force, Tachikawa, Tokyo, Japan. orui1690@inet.asdf.mod.go.jp
authors: Nobuhiro
authors: N
authors: Ohrui
authors: Tetsuya
authors: T
authors: Hisada
authors: Yukiko
authors: Y
authors: Tsujimoto
authors: Eiji
authors: E
authors: Shinto
authors: Yutaka
authors: Y
authors: Sakurai
authors: Koji
authors: K
authors: Fukushima
authors: Yoshinori
authors: Y
authors: Miyamoto
mesh_terms: D000328:Adult; D000337:Aerospace Medicine; D017668:Age of Onset; D053840:Brugada Syndrome / Q000453:epidemiology; D004562:Electrocardiography; D006331:Heart Diseases / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular; D008297:Male; D008875:Middle Aged; D008889:Military Personnel