Table 2

Recommendations for investigation of arrhythmias

Medical history including family history, physical examination, and ECG should be performed for all cases of suspected cardiac arrhythmiaHighly recommended
Second level evaluation for arrhythmia should include ambulatory ECG monitoring, echocardiography, an exercise ECG, and haematological and biochemical analysis.
In cases of suspected hypertension ambulatory blood pressure measurement is recommended.
Highly recommended
Depending on the type of arrhythmia and the aircrew role, third level evaluation with invasive electrophysiologic study plus possible catheter ablation, genetic testing or specific pharmacological tests may be appropriate.
Exclusion of underlying cardiac diseases may require cardiac MRI, cardiac CT, stress echocardiography and/or invasive coronary angiography. For aircrew of high performance aircraft, centrifuge testing to evaluate response to Gz acceleration may be useful.