Results of holter monitoring US Air Force aircrew with ectopy on 12-lead electrocardiograms

Purpose: To evaluate the results of 24-h Hotter monitoring performed on hea lthy U.S. Air Force aircrew with asymptomatic ectopy on resting electrocard iograms (ECG). Methods: A historical review of the USAF Central ECG Library database was conducted on all Hotter studies completed for evaluation of E CG ectopy between 1 Jan 86 and 31 Dec 97. Univariate and multivariate stati stical analyses were performed to determine the association between ectopy and the aeromedical dispositions of aircrew evaluated for incidental ECC ec topy. Results: During this period, 147,571 resting ECGs were submitted to t he Aeromedical Consultation Service (ACS) for interpretation. The mean age of the subjects was 35 yr (range 19 to 57 yr). There were 480 24-h Hotter s tudies performed for ECG ectopy. Of these, 49% had normal or normal variant findings; another 11% were found acceptable for flying after normal treadm ill testing and echocardiography. ACS evaluation was required for the remai ning 40% of subjects. Overall, 4% were permanently disqualified, and 17% we re lost to follow-up. Excluding subjects lost to follow-up, 95% of aircrew were returned to flying status (with or without a waiver). Conclusions: Whe n controlled for age, no significant difference of aeromedical outcome was seen when comparing supraventricular and ventricular ectopy. Of the subject s, 51% had abnormal Hotter studies, but the vast majority were returned to flying. Results of this study provide information useful in further definin g aircrew medical evaluation protocols for evaluation of asymptomatic ECC e ctopy with Holter monitoring.