Table 1 Recommendations for the assessment of ECG findings in aircrew [1]. BMI = body mass index; QTc = corrected QT-interval; yr = years; bpm = beats per minute
From: Electrocardiographic abnormalities in medically screened German military aircrew
Normal ECG variants | For normal variants, consider further investigation if… | ECG findings requiring further investigation | ECG findings disqualifying for high-risk duties unless treated, with resulting acceptable risk |
|---|---|---|---|
Sinus arrhythmia | Sino-atrial block (< 3 s/day, < 4 s/night) | Sinus arrest Sino-atrial block > 3 s/day, > 4 s/night | |
Ectopic atrial rhythm with inverted P waves in the inferior limb leads | Symptoms suggestive of tachycardia | ||
Sinus bradycardia ≥40 bpm | Sinus bradycardia < 40 bpm Junctional rhythm | Idioventricular rhythm | |
Sinus tachycardia > 100 bpm | Persistent sinus tachycardia > 100 bpm at rest | ||
1st degree AV block – PR < 300 ms | 1st degree AV block – PR > 300 ms | ||
2nd degree AV block Mobitz I (Wenckebach) | first appearance at age > 40 yr or if frequent, especially while awake | 2nd degree AV block Mobitz II 3rd degree AV block | |
Incomplete right bundle branch block Left anterior fascicular block | New Left anterior fascicular blockblock > 40 yr | Complete right bundle branch block Left bundle branch block Left posterior fascicular block | |
Single premature atrial complex (PAC) or premature junctional complex (PJC) | > 1 premature atrial complex (PAC) or premature junctional complex (PJC) Supraventricular tachycardia < 30 s | Supraventricular tachycardia > 30 s or symptomatic | |
Single premature ventricular complex (PVC) | > 1 premature ventricular complex (PVC) or ≥ 1 pair Ventricular tachycardia ≤11 beats | Ventricular tachycardia > 11 beats or symptomatic | |
Short PR interval 90-120 ms with no evidence of delta waves | Very short PR < 90 ms | asymptomatic ventricular pre-excitation | Wolff-Parkinson-White (WPW) syndrome |
Isolated QRS voltage criteria for left ventricular hypertrophy, especially in young people | Elevated BP, BMI > 30, age > 40 yr, or new finding | Left ventricular hypertrophy with strain | |
Atrial enlargement | Accompanied by axis deviation | ||
Right ventricular hypertrophy (R wave in V1 plus S wave in V5 or V6 > 10.5 mm) | |||
ST segment depression and/or negative T wave only in lead III | Diffuse T wave abnormality or ST changes | ||
QTc prolongation (QTc < 470 ms) | Family history of long QT syndrome | QTc > 470 ms but < 500 ms | QTc > 500 ms |
Early repolarization (benign form) - no evidence of delta waves | Brugada Type 2 | Brugada Type 1 pattern |