A 5-year review of atrial fibrillation in military aircrew.
BACKGROUND
Atrial fibrillation (AF) is a common cause of disqualification from flying in both civilian and military aircrew. We reviewed 5 yr of atrial fibrillation management in the Royal Air Force (RAF) from both a clinical and occupational perspective.


METHODS
Patients were identified from the RAF Medical Boards (RAFMB) electronic database using search terms "atrial," "fibrillation," and "arrhythmia." Management was compared to current RAF and national clinical guidelines and current civilian and military aviation medicine policy.


RESULTS
Over the 5-yr period assessed, 23 aircrew were identified with AF. Paroxysmal AF (PAF) was the most common diagnosis. Five aircrew remained fit to fly with no limitations, 12 fit to fly with restrictions, and 6 were graded permanently unfit for flying, with one of these being medically discharged.


CONCLUSIONS
The incidence and demographics of aircrew identified with AF in this paper is comparable to previous studies. All aircrew in our study were treated in accordance with current RAF/national guidelines. Emerging treatments such as radiofrequency ablation and the new anticoagulants remain to be assessed for suitability in a military context.


CONCLUSIONS
Management of AF in RAF aircrew requires a holistic approach, with an awareness of the arrhythmogenic aviation environment in which RAF aircrew operate. Most RAF aircrew with AF will retain a restricted flying status, but this should be considered on a case-by-case basis.
Clinical Aviation Medical Service, RAF Henlow, Bedfordshire, UK.
Alys H
AH
Hunter
Clinical Aviation Medical Service, RAF Henlow, Bedfordshire, UK.
Andrew C
AC
Timperley
Royal Air Force Medical Board, RAF Henlow, Bedfordshire, UK.
Alastair N C
AN
Reid
Royal Air Force Centre of Aviation Medicine, RAF Henlow, Bedfordshire, UK.
David C
DC
McLoughlin
Clinical Aviation Medical Service, RAF Henlow, Bedfordshire, UK.
Edward
E
Nicol
D000293:Adolescent; D000328:Adult; D000337:Aerospace Medicine; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy*; D017115:Catheter Ablation / Q000706:statistics & numerical data; D016208:Databases, Factual; D004554:Electric Countershock / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D006113:United Kingdom; D014938:Work Capacity Evaluation; D055815:Young Adult
D000889:Anti-Arrhythmia Agents