ABSTRACT
Cardiac arrhythmia is a major cause of restriction of flying duties. Arrhythmias in aircrew are of concern as they may cause incapacitation secondary to pre-syncope or syncope, or symptoms such as palpitations or dizziness that may impair the safe operation of an aircraft simply by distraction. For aircrew with confirmed arrhythmia, assessment of both the abnormal conduction abnormality and anti-arrhythmic therapy is critical as both may have flight safety implications. Aircrew periodic medical examination should include a thorough medical history, including family history, alcohol and caffeine intake, a physical examination and 12-lead ECG. Sinus bradycardia and sinus arrhythmia are common findings in active people; they often normalize during exercise and are usually asymptomatic. In isolation they are compatible with unrestricted flying duties. Atrial ectopy is usually benign and does not require further investigation, or restrictions, for aircrew, as long as not associated with haemodynamic symptoms.
