Hisada Tetsuya, Miyagawa Takashi, Tsujimoto Tetsuya, Maekawa Koichi, Sakai Miasao, Sakurai Yutaka, Ohsuzu Fumitaka
Department of Cardiology, National Defense Medical College, Namiki 3-2, Tokorozawa, Saitama 359-8513, Japan.
Aviat Space Environ Med. 2009 Feb;80(2):139-43. doi: 10.3357/asem.2379.2009.
Cardiovascular diseases can cause sudden incapacitation in aircrew. Cardiological diagnosis and therapy have changed a great deal in recent decades, as with coronary revascularization, including percutaneous coronary intervention and coronary artery bypass grafting for coronary artery disease, and electrophysiological studies and radiofrequency catheter ablation (RFCA) for sustained arrhythmias. Physicians need to be able to make appropriate, objective recommendations regarding cardiovascular diseases in an aeromedical waiver system.
We analyzed all 95 waiver cases regarding cardiovascular diseases in the Japan Air Self-Defense Force (JASDF), 1980-2007, and compared them to policies in the United States Air Force (USAF).
The JASDF and the USAF handle most conditions similarly, although there are differences regarding coronary revascularization, atrial fibrillation, non-sustained ventricular tachycardia (nsVT), and hypertrophic cardiomyopathy. The JASDF used RFCA more commonly for the treatment of aircrew with atrial fibrillation and nsVT Although routine follow-up with electrophysiological studies is no longer indicated for Wolff-Parkinson-White and atrioventricular node reentrant tachycardia in USAF policy, the JASDF still conducts reevaluation for all RFCA cases.
This study made recommendations to improve the JASDF waiver system for cardiovascular diseases.
心血管疾病可导致空勤人员突然丧失工作能力。近几十年来，心脏病学的诊断和治疗发生了很大变化，例如冠心病的血运重建，包括经皮冠状动脉介入治疗和冠状动脉旁路移植术，以及针对持续性心律失常的电生理研究和射频导管消融术（RFCA）。医生需要能够在航空医学豁免系统中就心血管疾病提出适当、客观的建议。
我们分析了1980年至2007年日本航空自卫队（JASDF）所有95例心血管疾病豁免病例，并将其与美国空军（USAF）的政策进行比较。
日本航空自卫队和美国空军在大多数情况下的处理方式相似，尽管在冠状动脉血运重建、心房颤动、非持续性室性心动过速（nsVT）和肥厚型心肌病方面存在差异。日本航空自卫队更常用射频导管消融术治疗心房颤动和非持续性室性心动过速的空勤人员。尽管根据美国空军政策，不再需要对预激综合征和房室结折返性心动过速进行常规电生理研究随访，但日本航空自卫队仍对所有射频导管消融术病例进行重新评估。
本研究提出了改进日本航空自卫队心血管疾病豁免系统的建议。
