Atrial Fibrilation and commercial flying

[heymrpilot]

Hey all...I hold a CASA Class 1 medical but don't work as a commercial pilot at this point, although i am going to soon. I had lone AF 4 years ago and naturally reverted with no further issues. Lately as i've been trying to get fitter i've noticed i'm getting palpitations whilst i'm exerting myself during exercise. If i jump off the running machine it goes away. CASA doesn't know about my lone AF incident but now that this problem is starting to rear its head again, i obviously need to do something about it. I am worried that if CASA finds out that i will potentially lose my medical. Are there any pilots out there who have AF in any way and are still flying. I would really like some advice as to how to proceed and whether i will still be able to fly with my condition. Thanks

[aviate1138]

Atrial Fibrillation is a very inexact science. There are also many variations of AF from Paroxysmal to Permanent. Some of us who have it wake up each morning as though we have run an overnight marathon. Main thing is to avoid the possibility of a stroke or haemorrhage which is a major AF effect.

I would seek very well sourced advice.

Check out this link.

If you are UK based.....

Home - Atrial Fibrillation (AFA) - AFA Home (http://www.atrialfibrillation.org.uk/)

Good luck

[homonculus]

At 38 this is good advice - go and see a doctor immediately. The reasons are multiple (not the as,e as an inexact science) but include ischamia - the arrhythmia at your age could well be a warning of other problems that need investigating. On top of this, if you do have AF you need to be considered for anticoagulants

You certainly should not fly apart from it being illegal not to inform your regulator

[gingernut]

How was it diagnosed ?

[heymrpilot]

It was diagnosed by a cardiologist. He told me that he used to get it too when he was training for marathons and as soon as he became less fit it never happened again. He told me not to worry about it and that it was something alot of fit people get and that it may never happen again but to monitor it. It hasn't ever happened to the degree it happened that first time. Now when i feel it, it is irregular for a very short interval and then returns to normal. I appreciate your replies but i'm really looking for an answer as to whether this is going to cause me to lose my CASA medical. I know this can be managed entirely effectively with Sotalol (approved for pilots) yet if i go and get a prescriptuon for it i have to tell CASA and want to know if they will cancel my licence due to this????

[Bad medicine]

You have to tell CASA whether you need medication or not. In fact the argument could be made that you don't have a medical now as your medical is based on falsifying your medical history. Even if you had a valid medical, you should have grounded yourself as soon as you became aware of the condition.

There are lots of pilots flying with a diagnosis of AF. Best to fess up now before you get caught!

[create_it83]

Broadly:

Your cardiovascular risk needs to be formally assessed: i.e. what is the possibility that you will suddenly keel over of a heart attack whilst in charge of an aircraft? Having an episode of AF proves you to be higher risk than another otherwise identical individual.

Full assessment is likely to include resting ECG, echocardiogram (to assess for structural problems or signs of old heart attack), and possibly stress testing / imaging. You would also need your cholesterol and other blood work looking at.

You would be unfit to fly until this is all sorted, but as others have said, once the risk is properly assessed it's entirely possible to retain a valid medical.

Remember: ordinary cardiologists, unless qualified as an aviation medical examiner, are not in any position to comment on your suitability for flying.

[heymrpilot]

Thank you create_it83 (http://www.pprune.org/members/212284-create_it83),

That was the reply i was looking for. Factual, informative and insightful. I will take your advice. I'd still like to hear from a pilot with AF though!

[heymrpilot]

Thanks everyone, I appreciate all the advice and will head to the DAME

[Jetpipe.]

I got AF while training (football) 2 years ago. It didn't go away by it self I had to use a defibrillator to convert back to sinus rhythm.. Since I was young and it was a first time event the agency put an OML (valid as or with qualified co-pilot) limitation in my medical for 6 months until I was able to show them that I was fit for flight.. Within these 6 months I did 2 ultrasounds, 2 stress tests, 2 48-hour ECG monitoring and normal ECGs, all tests showed no evidence of AF so I got my unrestricted MED-1 back! I assume that if I get it again it will be very difficult to maintain an unrestricted MED or maybe it will be a complete loss of MED-1.. Ι strongly suggest everyone with a similar condition to consider loss of MED-1 insurance.. I will certainly do it.. when I find a job ... :ugh:

[Lou Scannon]

I'm old and retired but I did develop the type of AF that starts and stops of its own accord ...just as I reached the then maximum age of 60.

I have had three Cardiac Catheter Ablations carried out, the first didn't work and the second wore off after 7 years (remember these were when it was largely an experimental procedure).

I have had my third some 18 months ago... on the NHS...and that has worked leaving me in normal rhythm apart from the odd missing beat which is not a problem.

For your own good health get checked out and consider an ablation should you need one.

[fortystripes]

Even if well controlled, atrial fibrillation is not something I would be comfortable knowing my pilot had.

The issue is not the heart rhythm itself, but what happens to blood as a result of the fibrillation. Atrial fibrillation causes the atria (the top part of the heart) to quiver instead of purposefully beating in sequence with the ventricles (bottom part of the heart). The quivering disrupts the smooth flow of blood, and this causes clots to form. These clots could kill someone in an instant, if they traveled to the brain (stroke), heart (myocardial infarct) or lung (pulmonary embolism).

I do not know the specifics of licensing, but would imagine it would involve several sequential EKGs showing the fibrillation is gone before license is granted.

[mach79]

It's not a case of possible stress testing-it is in fact required, and indeed other testing such as 24-hr ecg and echocardiograms.Candidates for tests have to meet precise standards laid out by the Authoriy.
An AME is no good either.I think you'll find that the only voice that matters is the Consultant Cardiologist to the CAA.

[scotbill]

Have had several episodes of fibrillation since retiring - usually stress related.

For what it's worth, the last one was stopped by a hypnotist three years ago when I was just about to embark on the hassle of Warfarin therapy.
No guarantee it would work for anyone else - but at least it's non-invasive.