Holter monitor findings in asymptomatic male military aviators without structural heart disease

Purpose: Our study was designed to determine the spectrum of Holter monitor findings in normal male military aviators to establish a reference for air crew populations with cardiac related diagnoses. Methods: We identified all individuals with normal cardiac catheterization in the United States Air F orce Aeromedical Consultation Service cardiac catheterization database from January 1984 to December 1998. Cases with valvular disease, left or right bundle branch block, and referral diagnoses of ectopy or arrhythmia were th en excluded. Results of Holter monitor studies performed on the remaining a viators prior to cardiac catheterization were then collected and tabulated. Frequency of isolated ectopy was classified as a percentage of the total b eats on the Holter monitor: rare (less than or equal to0.1%), occasional (> 0.1 to 1.0%), frequent (>1.0 to 10%) and very frequent (>10%). Results: Fro m 1575 consecutive cardiac catheterizations reviewed, 303 aviators met the above inclusion criteria. Only 36 of 303 (11.9%) had no ectopy at all. Rare , occasional, frequent and very frequent isolated atrial ectopy occurred in 72.9%, 2.6%, 23% and 0.3%, respectively. The same categories of isolated v entricular ectopy occurred in 40.9%, 7.9%, 3.3% and 0.0%. Atrial and ventri cular pairs occurred in 14.5% and 4.3%, respectively. Nonsustained supraven tricular and ventricular tachycardia (duration 3 to 10 beats) occurred in 4 .3% (13/303) and 0.7% (2/303), respectively. There were no sustained suprav entricular or ventricular tachycardias. Conclusions: In this population, ab sence of ectopy is unusual while rare isolated ectopy is common. These find ings may help define the aeromedical/clinical significance of Holter monito rs performed on aircrew with underlying cardiac complaints or diagnoses.