Characteristics of United States Military Pilots with Atrial Fibrillation

Abstract

INTRODUCTIONAtrial fibrillation (AF) is a recognized disqualifying condition for United States military pilots impacting deployments and retention. This study aims to characterize United States active duty (AD) pilots with AF and review deployment and retention rates associated with medical and ablative therapies. METHODSAn observational analysis was performed to assess AD pilots diagnosed with AF in the largest military regional healthcare system from 2004 to 2019. Baseline characteristics and AF management were reviewed.RESULTS27 AD pilots (mean age, 37.3±7.9 years; mean BMI, 27.3±3.1 kg/m2; 100% male sex) were diagnosed with AF during the study dates. 17 (63%) were Air Force pilots with hypertension as the most common risk factor (26%) and overall low CHA2DS2-VASc scores (mean 0.29±0.47). 22 (82%) pilots evenly received medical rate and rhythm strategies (41% and 41%, respectively). 16 (59%) underwent pulmonary vein isolation (PVI) with zero complications. 11 (41%) pilots received warfarin and 5 (19%) received a direct oral anticoagulant (DOAC) for stroke prevention. After diagnosis 12 (44%) pilots deployed and 25 (93%) were military retained. PVI was not associated with a change in subsequent deployments rates (PVI, 38% vs No PVI, 55%; p=0.3809) or retention rates (PVI, 94 % vs no PVI, 91%; p=0.7835).CONCLUSIONSUnited States military pilots diagnosed with AF are younger patients with few traditional AF risk factors. They receive medical rate and rhythm strategies equally. Many pilots maintain deployment eligibility and most remain on AD status after diagnosis. PVI is not associated with changes in retention or deployment rates.