Guide for Aviation Medical Examiners

Decision Considerations - Aerospace Medical Dispositions
Item 36. Heart - Arrhythmias

Common Conditions and Course of Action

Disease/Condition Class Evaluation Data Disposition
Bradycardia (<50 bpm) All Document history and findings, CVE Protocol (PDF), and submit any tests deemed appropriate If no evidence of structural, functional or coronary heart disease - Issue

Otherwise - Requires FAA Decision
Bundle Branch Block (Left and Right)

*IRBBB or ICVD (PDF)

All See Protocol for Bundle Branch Block (BBB) If no evidence of structural, functional or coronary heart disease - Issue

Otherwise - Requires FAA Decision
History of Implanted Pacemakers All See Pacemaker Disposition Table (PDF) Requires FAA Decision
PAC (2 or more on ECG)

See PAC Disposition Table (PDF)

All Requires evaluation, e.g., check for MVP, caffeine, pulmonary disease, thyroid, etc. If no evidence of structural, functional or coronary heart disease - Issue

Otherwise - Requires FAA Decision
PVC's (2 or more on standard ECG) All Max GXT - to include a baseline ECG If no evidence of structural, functional or coronary heart disease and PVC's resolve with exercise - Issue

Otherwise - Requires FAA Decision
1st Degree AV Block

with PR interval of LESS than 300 ms
All If no symptoms or AME concerns ISSUE
Annotate Item 60
1st Degree AV Block

with PR interval of 300 ms or MORE
All Submit the following:

A current Holter and cardiac evaluation
DEFER
Submit information to the FAA for review
2nd Degree AV Block

Mobitz I
All Document history and findings, CVE Protocol (PDF), and submit any tests deemed appropriate If no evidence of structural, functional or coronary heart disease - Issue

Otherwise - Requires FAA Decision
2nd Degree AV Block

Mobitz II
All CVE Protocol (PDF) in accordance w/ Hypertensive Evaluation Specifications and 24-hour Holter Requires FAA Decision
3rd Degree AV Block All CVE Protocol (PDF) in accordance w/ Hypertensive Evaluation Specifications and 24-hour Holter Requires FAA Decision
Preexcitation All CVE Protocol (PDF), GXT, and 24-hour Holter Requires FAA Decision
Radio Frequency Ablation

* If performed for atrial fibrillation AFib/A-Flutter (PDF), see that section first.

All 3-month wait, then 24-hour Holter If Holter negative for arrhythmia, no recurrence - Issue

Otherwise - Requires FAA Decision

Supraventricular Tachycardia All CVE Protocol (PDF) with ECHO and 24-hour Holter Initial Special Issuance - Requires FAA Decision

Followup Special Issuance's - See AASI Protocol
Last updated: Wednesday, March 27, 2024