![]() ![]() Īircrew, and particularly pilots, are subject to a unique and exacting working environment, especially in high-performance military flying. Stimulant use, excessive alcohol and caffeine intake should also be explored. Risk factors for AF include increasing age, hypertension, increased pulse pressure, diabetes mellitus, coronary artery disease, myocardial infarction, heart failure, obesity, obstructive sleep apnea, smoking, alcohol use, hyperthyroidism, family history, and certain genetic variants. The pathophysiology of AF is characterized by a complex interplay of triggers, perpetuators, and substrate development. Currently, >11 million patients are estimated to have AF in Europe, and the total healthcare costs of AF account for ≤2.6% of total healthcare expenditure in Europe. The global prevalence of atrial fibrillation (AF) has increased substantially over the past three decades and is currently approximately 60 million cases. Atrial fibrillation (AF) is the most common arrhythmia worldwide. Aeromedical disposition should be case-by-case based on aeromedical regulations, individual clinical findings, and specific occupational requirements in this challenging field of work.Ĭardiovascular disease is the most common reason for loss of flying privileges for both military and civilian pilots in Western Europe, and cardiac arrhythmias are the main disqualifier. Management of AF in military aircrew requires a comprehensive approach regarding the flight environment as well as clinical guidance. 36/42 aircrew were returned to flight status with restrictions, while 6/42 were permanently disqualified from flying. Long-term recurrence prevention was variable with catheter ablations in 8 cases. In 27 aircrew (64%) AF terminated spontaneously. The breakdown of events and occurrence was found to be: single (23), paroxysmal (16), persistent (2), permanent (1). The median follow-up period was 5.35 years. The median age at initial diagnosis was 47 years (min 22 years, max 62 years). In 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. 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. The 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. 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. Aircrew, and particularly pilots, are subject to a unique and exacting working environment, especially in high-performance military aircraft. Arrhythmias 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. ![]()
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