Results of Holter monitoring U.S. Air Force aircrew with ectopy on 12-lead electrocardiograms

Abstract

Purpose: To evaluate the results of 24-h Holter monitoring performed on healthy U.S. Air Force aircrew with asymptomatic ectopy on resting electrocardiograms (ECG).

Methods: A historical review of the USAF Central ECG Library database was conducted on all Holter studies completed for evaluation of ECG ectopy between 1 Jan 86 and 31 Dec 97. Univariate and multivariate statistical analyses were performed to determine the association between ectopy and the aeromedical dispositions of aircrew evaluated for incidental ECG ectopy.

Results: During this period, 147,571 resting ECGs were submitted to the 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 Holter studies performed for ECG ectopy. Of these, 49% had normal or normal variant findings; another 11% were found acceptable for flying after normal treadmill testing and echocardiography. ACS evaluation was required for the remaining 40% of subjects. Overall, 4% were permanently disqualified, and 17% were lost to follow-up. Excluding subjects lost to follow-up, 95% of aircrew were returned to flying status (with or without a waiver).

Conclusions: When controlled for age, no significant difference of aeromedical outcome was seen when comparing supraventricular and ventricular ectopy. Of the subjects, 51% had abnormal Holter studies, but the vast majority were returned to flying. Results of this study provide information useful in further defining aircrew medical evaluation protocols for evaluation of asymptomatic ECG ectopy with Holter monitoring.