Considerations
Pacemakers have a failure rate well below 1% per annum. The leads have a higher risk of failure, of around 1% per annum. Regular pacemaker checks will often detect failing leads in good time. Modern pacemakers will also record episodes of arrhythmia that can be identified by downloading the data during checks.
Unipolar pacemakers may interfere with aircraft systems and are usually not acceptable. Bipolar pacemakers are not likely to interfere with aircraft systems. They are generally acceptable. Implanted Cardiac Defibrillators of any kind (ICD) are not acceptable unless deactivated and no longer necessary.
Information to be provided
On the first occasion that an applicant presents with a history of pacemaker implantation:
- Copy of all cardiologists’ reports; and
- Copy of all investigations reports;
- Copy of all pacemakers check reports;
On subsequent occasions:
- Copy of all subsequent cardiologists’ reports;
- Copy of all interim pacemaker check reports;
- Report of investigations as recommended by the treating cardiologist and / or requested by CAA.
Disposition
An applicant with an implanted cardiac defibrillator (ICD):
- Should be considered as having a condition that is of aeromedical significance. A certificate is unlikely to be issued.
An applicant with a Pacemaker may be considered as having a condition that is not of aeromedical significance if:
- An earlier AMC allowed for an unrestricted medical certificate in regard to the implanted device;
- There has been no change of condition;
- There is no associated cardiac condition that is of aeromedical significance;
- The device is fitted with bipolar leads;
- The applicant is not pacemaker dependant;
- The applicant undergoes pacemaker checks as recommended by the treating physician, at least 6 monthly;
- A recent pacemaker check was normal and did not reveal concerning arrhythmia.
