Table 1

Recommendations for ECG findings in aircrew

Normal ECG variantsFor normal variants, consider further investigation if…ECG findings requiring further investigation for aircrew medical certificationECG findings disqualifying for aircrew duties unless treated, with resulting acceptable aeromedical risk
Sinus arrhythmiaSino-atrial block (<3 s/day, <4 s/night)Sinus arrest
Sino-atrial block >3 s during day, >4 s night
Ectopic atrial rhythm with inverted P waves
Sinus bradycardia ≥40 beats per min (bpm)Sinus bradycardia <40 bpm
Junctional rhythm
Idioventricular rhythm
Sinus tachycardia >100 bpmPersistent sinus tachycardia >100 bpm at rest
I° atrioventricular (AV) block – PR <300 msI° AV block – PR >300 ms
II°AV block- Mobitz type I (Wenckebach)First appearance at age >40 years or if frequent, especially while awakeSecond degree AV block (Mobitz type II)
Third degree AV block
Incomplete right bundle branch block (RBBB)
Left anterior fascicular block (LAFB)
New LAFB block >40 yearsComplete RBBB
Left bundle branch block (LBBB)
Left posterior fascicular block (LPFB)
Single premature atrial complex (PAC) or premature junctional complex (PJC)>1 PAC or PJC
Supraventricular tachycardia (SVT) <30 s
SVT >30 s or symptomatic
Single premature ventricular complex (PVC)>1 PVC or ≥1 pair
Ventricular tachycardia (VT) ≤11 beats
VT >11 beats or symptomatic
Short PR interval 90–120 ms with no evidence of delta wavesVery short PR <90 msAsymptomatic ventricular pre-excitationWolff-Parkinson-White (WPW) syndrome
Isolated QRS voltage criteria for left ventricular hypertrophy, especially in young peopleElevated blood pressure, body mass index >30, age >40 years, or new findingLeft ventricular hypertrophy with strain
Atrial enlargementAccompanied by axis deviation
Right ventricular hypertrophy (R wave in V1 plus S wave in V5 or V>10.5 mm)
ST segment depression and/or negative T wave only in lead IIIDiffuse T wave abnormality or ST changes
QTc prolongation (QTc <470 ms)QTc >470 ms but <500 msQTc >500 ms
Early repolarisation (benign form) – no evidence of delta wavesBrugada type 2Brugada type 1 pattern