Sinus node arrest and sinoatrial block

Consideration

Sinus pauses may at time be seen in athletes with high vagal tones. Sinus node dysfunction can lead to pauses or tachyarrhythmia. The condition usually progresses slowly with no complications for sustained periods, but will eventually become problematic, requiring a pacemaker.

Asymptomatic applicants found to have sinoatrial dysfunction at routine ECG can often be certificated following investigations, with ongoing surveillance.

Information to be provided

On the first occasion that an applicant present with an abnormal ECG suggesting sinoatrial disease:

• A cardiologist report;
• 24h Holter monitor;
• Other tests as suggested by the cardiologist or CAA. This may include ElectroPhysiology study.

On subsequent occasions that an applicant present with an abnormal ECG suggesting sinoatrial disease:

• Investigations results as recommended following earlier cardiologist review, or by CAA.

Disposition

• An applicant with evidence of, or suspected sinoatrial disease should be considered as having a condition that is of aeromedical significance.

A certificate is likely to be issued if the applicant is asymptomatic, there are no pauses longer than 2.5 sec, no complex or sustained rhythm disturbance, and no other unacceptable characteristic have been identified.