WPW SYNDROME IN A JAPAN SMALL JET PILOT.

INTRODUCTION: In this case report we will describe a Japanese military U-125 Pilot who was found to have WPW syndrome during his annual aviation medical examination and returned to flight duties through catheter ablation. BACKGROUND: Wolff-Parkinson-White syndrome, or WPW syndrome, is a cardiac arrhythmia characterized by an abnormal electrical pathway in the heart. Normally, the heart's contractions are regulated by a specific pathway, but in WPW syndrome, an abnormal pathway known as an "accessory pathway" exists. This can lead to rapid and irregular heartbeats. One specific arrhythmia associated with WPW syndrome is called "pseudo ventricular tachycardia." In this condition, the abnormal pathway allows the ventricles to be excited prematurely, resulting in a faster heartbeat than usual. This pseudo ventricular tachycardia is distinct from regular ventricular tachycardia. When pseudo ventricular tachycardia occurs, the heart rate becomes very fast, and the rhythm becomes irregular. Symptoms may include dizziness, shortness of breath, and chest discomfort. In severe cases, loss of consciousness can occur. CASE PRESENTATION: The pilot was 46 years old when an electrocardiogram during an aviation medical examination showed ventricular tachycardia-like waveforms, and he was suspended from flight duties. He underwent cardiac electrophysiology testing, was diagnosed with WPW syndrome, and underwent catheter ablation. One month after the ablation, he underwent echocardiography, Holter ECG, and exercise stress ECG, none of which showed arrhythmia. Aeromedical Evaluation Board allowed him to return to flight duties on conditions. No further problematic arrhythmias were found. Another Aeromedical Evaluation Board was conducted, with arrythmia mitigated, he was returned to fly. DISCUSSION: At JASDF, the Aeromedical Evaluation Board determines whether a pilot who fails an aviation medical examination is allowed to return to flight duties. Ablation for WPW syndrome generally has a high success rate. However, in some patients with multiple abnormal conduction pathways, other conduction pathways may cause recurrence, so it is necessary to define appropriate evaluation criteria for each patient with WPW syndrome. This presentation will discuss the flight conditions imposed on pilots and the measures used by Japan, Iraq, and the US military for various arrhythmias. Learning Objectives 1. The audience will learn about the presentation, diagnosis, and/or treatment of an interesting Aerospace Medicine case. 2. The audience will learn about the similarities and differences in medical standards and pilot medical clearances for civilian, US and foreign military aviation professionals. [ABSTRACT FROM AUTHOR]