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Wed, Feb 01, 2023

FAA's ECG Policy Sees Reform

Updates to Electrocardiogram Approach Grant ME's More Latitude

The EAA has weighed in on changes to the FAA's standards on electrocardiogram (ECG) findings, complimenting it as part of a "pattern of positive reform".

The change will help to minimize the hassles and diagnostics required for those with abnormal - but asymptomatic and acausal - ECG readings for medical applicants. The change should decrease the chances of an undue medical deferral. Class II and III medical holders are not subject to routine ECG testing, but a similar change was implemented for heart arrhythmias.

The change allows airmen with a “First-degree AV (atrioventricular) block with PR interval less than 300 ms (0.30 sec)” to receive a medical certificate sans deferral. This change was actually known informally to the aeromedical community as far back as 2018 but was formalized in the October change to the FAA’s list of 18 “normal abnormal” ECG findings that do not require medical deferral. The change comes after studious examination of such cases over the years in which a firm pattern was found - the results may be abnormal compared to the baseline, but they don't indicate actual unwellness or risk to flight.

The EAA perhaps sought to clear the name of the head of the FAA’s Office of Aerospace Medicine, Federal Air Surgeon Dr. Susan Northrup. Grateful for her clear headed approach to minimizing undue hassle for pilots, the org hopes to clear her name of any suspicion now that certain cardiac elements in the cultural zeitgeist catch a leery eye.

"Unfortunately, there have been recent allegations that the ECG change was due to an ulterior, political motive," the EAA statement reads. "This is absolutely false, and the associated personal attacks on Dr. Northrup, a career public servant and U.S. Air Force veteran, are inexcusable. Given the criticism, often warranted, that aeromedical certification is too difficult in the United States, it is ironic that a change that removed a medically unnecessary barrier to easy certification has garnered controversy."

Dr. Stephen Leonard, EAA Aeromedical Advisory Council chairman, noted that the change primarily saves airmen time and money. Under the old system, anyone unfortunate enough to draw a short straw in the ECG results could easily wind up with hours of medical tests in an effort to clear his name. 

“Rather than requiring AMEs to defer the exams of pilots showing those changes, and requiring the pilot to schedule consultation with a cardiologist and a few thousand dollars’ worth of testing, FAA authorizes us as physician examiners to question the pilot, verify that there are no associated symptoms or other conditions that might indicate a clinically significant cardiac issue, and go ahead and issue the medical certificate.”

Leonard further clarified that “we still send the EKG to the FAA, their doctors still review it, and if they have any question, they follow up. Never, in 42 years as an AME, have I seen one of those ‘normal abnormals’ turn out to be clinically or aeromedically significant.”

FMI: www.eaa.org

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