Waivers for Cardiovascular Diseases in Military Aircrew: Differences Between Japanese and U.S. Protocols

Abstract

This study made recommendations to improve the JASDF waiver system for cardiovascular diseases.

Ventricular Fibrillation Diagnosed During Electrophysiological Study for Non-Sustained Tachycardia

“…Drug therapy using cardiovascular medications such as isoproterenol, quinidine, disopyramide, and bepridil have been clinically successful, but the JASDF does not allow the use of any antiarrhythmic drugs ( 7 ) in activeduty pilots. The JASDF also prohibits ICD implantation and RFCA for prevention of VF attack in active-duty pilots ( 7 ). These aeromedical dispositions policies regarding clinical therapy for Brugada syndrome are similar to those in other countries ( 11 ).…”

“…Aeromedical disposition is made from both clinical and aviation safety viewpoints, using a waiver guide for each civilian or military organization ( 7 , 11 ). The Japan Air Self-Defense Force (JASDF) does not allow the use of antiarrhythmic drugs and restricts pilots with three or more consecutive ventricular beats without electrophysiological study (EPS) evaluation to fl ight duty only with another pilot ( 7 ). Diagnosis and therapy for arrhythmia using catheter techniques have rapidly developed and radiofrequency catheter ablation (RFCA) therapy has allowed several aircrew diagnosed with tachyarrhythmia, including non-sustained ventricular tachycardia (nsVT), to return to fl ight duties without antiarrhythmic medications ( 4 , 11 ).…”

Decadal Electrocardiographic Changes Between Age 40 and 50 in Military Pilots

“…The main surveillance procedure for cardiovascular disease at this annual examination is 12-lead ECG. Additional cardiac examinations using echocardiography and treadmill exercise tests are conducted when ECG abnormalities are detected ( 4 ).…”