FAA Office of Aerospace Medicine
Civil Aerospace Medical Institute

Report No: DOT/FAA/AM-17/10

Title and Subtitle: Descriptive Characteristics of Atrial Fibrillation in Civil Aviation 1993-2005

Report Date: April 2017

Authors: Véronneau SJH, Rogers P

Abstract:
Introduction: This study was undertaken to examine the aviation safety and aeromedical aspects of certifying pilots with the medical condition of atrial fibrillation (AFIB). Results of this study are of use to aerospace medical practitioners, clinicians, flight safety analysts, and aeromedical certification specialists. Atrial fibrillation is the most common heart rhythm disorder among pilots, some estimates of atrial fibrillation prevalence in the general US population suggest it may become as common as one in four individuals in the near future. A threefold increase in AFIB among pilots has been seen over the study period.

Methods: For a 13-year period from 1993-2005 the electronic medical records of pilots with AFIB and all other pilots were compared for a variety of factors including: age, gender, experience, self-reported flight hours flown, pilot certifications, and medical class issued. Algorithms were constructed to allow the determination of the number of months for a pilot's active status, effective medical class, and accurate ages. Select hardcopy records were reviewed to document the clinical status of AFIB mishap pilots.

Results: Atrial fibrillation pilots as a group are older. They are as safe, and perhaps safer than pilots in general. Their percentage of mishaps that were human factor related was less (67.4 versus 81.3%) than all other pilots grouped together. AFIB pilots have 0.36% of the NTSB events during this period; they did not have any in-flight incapacitations. The only NTSB events due to AFIB as a cause or factor were among 3 events where the pilots were not properly certified and thus did not hold valid medical certificates. In one fatal case, an AME and the event pilot colluded to deceive FAA medical certification authorities. In the study period very few pilots participated by keeping an active medical for the entire interval, indicating there is a great deal of churn among airmen medical certificate applications.

Conclusion: The methodologies developed in this study will be used to examine many other conditions of aeromedical interest and other mishap factors of interest to mishap investigators, as well as certification and regulation authorities. A long period of observation, documentation of large number of pilots and careful attention to data quality issues were necessary to allow comparison of a group of 6,721 AFIB pilots, which comprised only 0.44% of the total 1,526,889 pilot population during 1993-2005.

Key Words: Aeromedical Certification, Atrial Fibrillation, Aviation Safety, Epidemiology, Aviation Medicine, Scientific Information System, Data Mining, Decision Support System, Data Warehouse, Database

No. of Pages: 25