My Flight Surgeon
Sr. Aviation Medical Examiner
This is another in the series of condition for which the FAA grants Special Issuance certificates.
As with all other conditions, the FAA will want to review the entire medical record. Your AME or www.faaspecialissuance.com can assist you in preparing your records for submission.
The topic today is Paroxysmal Atrial Tachycardia (PAT) or Supraventricular Tachycardia.
Supraventricular tachycardia (SVT) is an abnormal fast heart rhythm that starts in the upper chambers, or the atria, of the heart. (Supraventricular means above the ventricles, tachy means fast, and cardia means heart.)
Normally, the heart's electrical system precisely controls the rhythm and rate at which the heart beats. In supraventricular tachycardia, abnormal electrical connections (or abnormal firing of the connections) cause the heart to beat too fast. Typically, during supraventricular tachycardia episodes, the heart speeds up to rates of 150 to 200 beats per minute and occasionally as high as 300. After some time, the heart returns to a normal rate (60 to 100 beats per minute) on its own or after treatment.
Supraventricular tachycardia (SVT) is also called paroxysmal supraventricular tachycardia (PSVT) or paroxysmal atrial tachycardia (PAT).
What causes supraventricular tachycardia?
Most supraventricular tachycardia results from abnormal electrical connections in the heart that short-circuit the normal electrical system. What causes these abnormal pathways is not clear. In the case of Wolff-Parkinson-White syndrome, the condition may be inherited in some cases.
What are the symptoms?
With supraventricular tachycardia, you may have palpitations, an uncomfortable feeling that your heart is racing or pounding. You may also notice that your pulse is rapid or see or feel your pulse pounding, especially at your neck, where large arteries are close to the skin. Additional symptoms include feeling dizzy or lightheaded, near-fainting or fainting, shortness of breath, chest pain, throat tightness, and sweating.
How is supraventricular tachycardia diagnosed?
A description of your symptoms is one of the most important clues in diagnosing supraventricular tachycardia.Your doctor will ask what, if anything, triggers the episodes, how long they last, and whether anything stops them.
Because supraventricular tachycardia is a problem with your heart's electrical system, the most important test is EKG. An EKG measures the heart's electrical activity and can record supraventricular tachycardia episodes. An EKG is usually done along with a medical history and physical examination, lab tests, and a chest X-ray..
If you do not have an episode of supraventricular tachycardia while at the doctor's office, your doctor will probably ask you to wear a portable EKG to record your heart rhythm on a continuous basis. This is referred to by several names, including ambulatory electrocardiogram, ambulatory ECG, Holter monitoring, 24-hour EKG, or cardiac event monitoring. This will allow your heart rhythm to be recorded while you are having supraventricular tachycardia.
Your doctor may also recommend an electrophysiology (EP) study. In this test, flexible wires are inserted into a vein, usually in the groin, and threaded into the heart. Electrodes at the end of the wires send information about the heart's electrical activity. In this way, the EP study can map any abnormal electrical activity, identify the type of supraventricular tachycardia you have, and guide treatment.
How is it treated?
Some supraventricular tachycardias do not cause symptoms and may not need treatment. However, when symptoms occur, treatment is usually recommended.
Your doctor may teach you how to perform vagal maneuvers, such as the Valsalva maneuver or coughing, to slow your heart rate. If vagal maneuvers do not work, a fast-acting intravenous (IV) medication such as adenosine or verapamil can be given. If the arrhythmia does not stop and symptoms are severe, electrical cardioversion, in which a brief electric shock is given to the heart to reset the heart rhythm, may be needed.
If supraventricular tachycardia recurs, you may need long-term treatment, including:
AME Assisted Special Issuance (AASI) is a process that provides Examiners the ability to re-issue an airman medical certificate under the provisions of an Authorization for Special Issuance of a Medical Certificate (Authorization) to an applicant who has a medical condition that is disqualifying under Title 14 of the Code of Federal Regulations
(14 CFR) part 67.
An FAA physician provides the initial certification decision and grants the Authorization in accordance with 14 CFR 67.401. The Authorization letter is accompanied by attachments that specify the information that treating physician(s) must provide for the re-issuance determination. If this is a first time issuance of an Authorization for the above disease/condition, and the applicant has all of the requisite medical information necessary for a determination, the Examiner must defer and submit all of the documentation to the AMCD or Regional Flight Surgeon for the initial determination.
Examiners may re-issue an airman medical certificate under the provisions of an Authorization, if the applicant provides the following: [/FONT]
As with all other conditions, the FAA will want to review the entire medical record. Your AME or www.faaspecialissuance.com can assist you in preparing your records for submission.
The topic today is Paroxysmal Atrial Tachycardia (PAT) or Supraventricular Tachycardia.
Supraventricular tachycardia (SVT) is an abnormal fast heart rhythm that starts in the upper chambers, or the atria, of the heart. (Supraventricular means above the ventricles, tachy means fast, and cardia means heart.)
Normally, the heart's electrical system precisely controls the rhythm and rate at which the heart beats. In supraventricular tachycardia, abnormal electrical connections (or abnormal firing of the connections) cause the heart to beat too fast. Typically, during supraventricular tachycardia episodes, the heart speeds up to rates of 150 to 200 beats per minute and occasionally as high as 300. After some time, the heart returns to a normal rate (60 to 100 beats per minute) on its own or after treatment.
Supraventricular tachycardia (SVT) is also called paroxysmal supraventricular tachycardia (PSVT) or paroxysmal atrial tachycardia (PAT).
What causes supraventricular tachycardia?
Most supraventricular tachycardia results from abnormal electrical connections in the heart that short-circuit the normal electrical system. What causes these abnormal pathways is not clear. In the case of Wolff-Parkinson-White syndrome, the condition may be inherited in some cases.
What are the symptoms?
With supraventricular tachycardia, you may have palpitations, an uncomfortable feeling that your heart is racing or pounding. You may also notice that your pulse is rapid or see or feel your pulse pounding, especially at your neck, where large arteries are close to the skin. Additional symptoms include feeling dizzy or lightheaded, near-fainting or fainting, shortness of breath, chest pain, throat tightness, and sweating.
How is supraventricular tachycardia diagnosed?
A description of your symptoms is one of the most important clues in diagnosing supraventricular tachycardia.Your doctor will ask what, if anything, triggers the episodes, how long they last, and whether anything stops them.
Because supraventricular tachycardia is a problem with your heart's electrical system, the most important test is EKG. An EKG measures the heart's electrical activity and can record supraventricular tachycardia episodes. An EKG is usually done along with a medical history and physical examination, lab tests, and a chest X-ray..
If you do not have an episode of supraventricular tachycardia while at the doctor's office, your doctor will probably ask you to wear a portable EKG to record your heart rhythm on a continuous basis. This is referred to by several names, including ambulatory electrocardiogram, ambulatory ECG, Holter monitoring, 24-hour EKG, or cardiac event monitoring. This will allow your heart rhythm to be recorded while you are having supraventricular tachycardia.
Your doctor may also recommend an electrophysiology (EP) study. In this test, flexible wires are inserted into a vein, usually in the groin, and threaded into the heart. Electrodes at the end of the wires send information about the heart's electrical activity. In this way, the EP study can map any abnormal electrical activity, identify the type of supraventricular tachycardia you have, and guide treatment.
How is it treated?
Some supraventricular tachycardias do not cause symptoms and may not need treatment. However, when symptoms occur, treatment is usually recommended.
Your doctor may teach you how to perform vagal maneuvers, such as the Valsalva maneuver or coughing, to slow your heart rate. If vagal maneuvers do not work, a fast-acting intravenous (IV) medication such as adenosine or verapamil can be given. If the arrhythmia does not stop and symptoms are severe, electrical cardioversion, in which a brief electric shock is given to the heart to reset the heart rhythm, may be needed.
If supraventricular tachycardia recurs, you may need long-term treatment, including:
- [FONT="]Beta-blocker or other antiarrhythmic medications to slow heart rate.[/FONT]
- [FONT="]Catheter ablation, which is usually done during an electrophysiology (EP) study. Radio waves (radiofrequency energy) are directed through the catheter to the specific heart tissue that is generating abnormal electrical impulses. The radio waves cause the area of the heart muscle to be heated and selectively destroyed, eliminating the SVT.[/FONT]
AME Assisted Special Issuance (AASI) is a process that provides Examiners the ability to re-issue an airman medical certificate under the provisions of an Authorization for Special Issuance of a Medical Certificate (Authorization) to an applicant who has a medical condition that is disqualifying under Title 14 of the Code of Federal Regulations
(14 CFR) part 67.
An FAA physician provides the initial certification decision and grants the Authorization in accordance with 14 CFR 67.401. The Authorization letter is accompanied by attachments that specify the information that treating physician(s) must provide for the re-issuance determination. If this is a first time issuance of an Authorization for the above disease/condition, and the applicant has all of the requisite medical information necessary for a determination, the Examiner must defer and submit all of the documentation to the AMCD or Regional Flight Surgeon for the initial determination.
Examiners may re-issue an airman medical certificate under the provisions of an Authorization, if the applicant provides the following: [/FONT]
- [FONT="]An Authorization granted by the FAA;[/FONT]
- [FONT="]A statement regarding any recurrences since the last FAA medical examination; and[/FONT]
- [FONT="]The name and dosage of medication(s) used for treatment and/or prevention with comment regarding side effects.[/FONT]
- [FONT="]There have been one or more recurrences; or[/FONT]
- [FONT="]The applicant has received some treatment that was not reported in the past, such as radiofrequency ablation.[/FONT]