Key result
PVI shows no association with improved deployment or retention rates in military pilots with AF.
Why the study?
Atrial fibrillation impacts deployment and retention rates for United States military pilots, but characteristics and outcomes related to medical and ablative therapies are not well characterized.
Does medical or ablative therapy for atrial fibrillation affect deployment and retention rates in United States military pilots?
Observational (n=27)
No
Does medical or ablative therapy for atrial fibrillation affect deployment and retention rates in United States military pilots?
In a cohort of US military pilots with atrial fibrillation, most remained on active duty and many maintained deployment eligibility, with pulmonary vein isolation showing no significant impact on these occupational outcomes.
Answers are grounded in this paper and cite their sources.
Should not yet alter ablation decisions for military pilots with AF; leaves open PVI effects on occupational outcomes.
INTRODUCTION: Atrial fibrillation (AF) is an arrhythmia that impacts deployment and retention rates for United States military pilots. 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. METHODS: An 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. RESULTS: -VASc scores (mean 0.29 ± 0.47). 22 (82%) pilots were equally treated with 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 for stroke prevention. After diagnosis, 12 (44%) pilots deployed and 25 (93%) were retained in military. 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). CONCLUSIONS: United States military pilots diagnosed with AF are younger patients with few traditional AF risk factors and 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 differences in retention or deployment rates. Further prospective study is needed to further evaluate these findings.
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Keithler et al. (2022) conducted an observational in Atrial fibrillation (n=27). Pulmonary vein isolation (PVI) vs. No PVI was evaluated on Subsequent deployment rate (p=0.3809). In active duty military pilots with atrial fibrillation, pulmonary vein isolation was not associated with a significant change in subsequent deployment rates (38% vs 55%, p=0.3809) or retention rates.
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