'Incomplete' Right Bundle Branch Block
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Join Date: Sep 2012
Location: Scranton
Age: 60
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'Incomplete' Right Bundle Branch Block
Hi,
I completed a Class 2 initial medical today and everything was excellent up until my ECG where it diagnosed an 'Incomplete Right Bundle Branch Block' but no other issues. My AME didn't really seem sure on what to do with this and was surprised given my other results and lifestyle/health in general so asked that I take the ECG to a local private clinic. As a (now) poor working student I'm not sure I can get the time or money to do this or wait ages on the NHS to help me out.
Later in the day I was checking the CAA website, specifically on this document:
http://www.caa.co.uk/docs/1859/JARGuidanceV3-07.pdf
On page 35 (51 of the pdf document) it states that
(e) Applicants with complete right
bundle branch block require
cardiological evaluation on first
presentation and subsequently in
compliance with appropriate items in
paragraph 7 Appendix 1 to Subpart
B.
RBBB algorithm January 2005
Incomplete Right Bundle Branch
Block
This does not require investigation. The
RBBB algorithm only applies to complete
right bundle branch block. (Incomplete
RBBB - QRS complex up to 0.11 sec;
complete RBBB - QRS complex 0.12 sec
or more). June 1997
After checking with the CAA at Gatwick about the issue, they said they have no problem with it and cannot deny a medical due to this with regard to the ECG's diagnosis. Do I have a case for asking the AME to re-consider, given this document's contents? He is a pilot himself and rather approachable but wanted to make sure that I have read and interpreted the 'theory' correctly.
Thanks in advance
I completed a Class 2 initial medical today and everything was excellent up until my ECG where it diagnosed an 'Incomplete Right Bundle Branch Block' but no other issues. My AME didn't really seem sure on what to do with this and was surprised given my other results and lifestyle/health in general so asked that I take the ECG to a local private clinic. As a (now) poor working student I'm not sure I can get the time or money to do this or wait ages on the NHS to help me out.
Later in the day I was checking the CAA website, specifically on this document:
http://www.caa.co.uk/docs/1859/JARGuidanceV3-07.pdf
On page 35 (51 of the pdf document) it states that
(e) Applicants with complete right
bundle branch block require
cardiological evaluation on first
presentation and subsequently in
compliance with appropriate items in
paragraph 7 Appendix 1 to Subpart
B.
RBBB algorithm January 2005
Incomplete Right Bundle Branch
Block
This does not require investigation. The
RBBB algorithm only applies to complete
right bundle branch block. (Incomplete
RBBB - QRS complex up to 0.11 sec;
complete RBBB - QRS complex 0.12 sec
or more). June 1997
After checking with the CAA at Gatwick about the issue, they said they have no problem with it and cannot deny a medical due to this with regard to the ECG's diagnosis. Do I have a case for asking the AME to re-consider, given this document's contents? He is a pilot himself and rather approachable but wanted to make sure that I have read and interpreted the 'theory' correctly.
Thanks in advance
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I've had mine for at least the last 45 years. (full disclosure: never applied for a Class I) It will always result in an "abnormal" ecg.
Sounds like cardiology is not your AME's strong suit. Your CAA info seems consistent with current theory regarding incomplete RBBB.
Why not take the CAA page back and ask for a reconsideration?
Sounds like cardiology is not your AME's strong suit. Your CAA info seems consistent with current theory regarding incomplete RBBB.
Why not take the CAA page back and ask for a reconsideration?
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obgraham,
I have done and he has signed me off as fit to fly! Thanks for the confirmation as I just wanted to make sure I had interpreted this correctly.
I have done and he has signed me off as fit to fly! Thanks for the confirmation as I just wanted to make sure I had interpreted this correctly.
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The incomplete RBBB is not an actual "block," but a delay (we're talking about milliseconds) on the conduction of the electrical impulse through the right branch of the His bundle ... well, you know:-)
The modern, digital ECG machines indicate "abnormal" just because they have been setup with a range of data for the duration of the various ECG waves, generated by the electrical activity in the cells of the cardiac muscle.
Years ago, in cases of IRBBB doctors would recommend a more thorough cardiac examination to rule out morphological or functional defects of the heart muscle. Over the past few years, the need for further investigation has been waved in view of improved understanding of electrocardiography.
Like many other pilots, I have had it for 59 years ... always held a class one medical.
The modern, digital ECG machines indicate "abnormal" just because they have been setup with a range of data for the duration of the various ECG waves, generated by the electrical activity in the cells of the cardiac muscle.
Years ago, in cases of IRBBB doctors would recommend a more thorough cardiac examination to rule out morphological or functional defects of the heart muscle. Over the past few years, the need for further investigation has been waved in view of improved understanding of electrocardiography.
Like many other pilots, I have had it for 59 years ... always held a class one medical.
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Never a Problem Either
I have the same condition. I've held 5 licenses from different NAAs with no questions asked. Furthermore, I have a private medical that includes a Bruce Protocol stress treadmill test and everything works fine. I've held a class 1 medical for 42 years.
