Pacemaker

Heart and Circulatory System—Pacemaker

Pacemaker

A two-month recovery and stabilizing period is required after the pacemaker is inserted before you can apply for a special issuance. A complete cardiovascular evaluation will need to be done after the 60-day recovery and stabilization period is over.


The packet must include:
1. Copies of hospital/medical records pertaining to the clinical indications for the pacemaker, including:
  •  make and model of the generator and leads;
  •  serial numbers of generator and leads;
  •  admission history and physical
  •  operative report;
  •  discharge summary.
2. An evaluation of pacemaker function including: 
  •  Description and documentation of underlying rate and rhythm with the pacemaker turned "off" or at the lowest setting (pacemaker dependency); 
  •  Programmed pacemaker parameters; 
  •  Surveillance records; 
  •  Exclusion of myopotential inhibition and pacemaker-induced hypotension (pacemaker syndrome); 
  •  Power pack data including beginning of life (BOL) and elective replacement indicator/end of life (ERI/EOL).
  •  Legible samples of all electronic pacemaker surveillance records since the pacemaker insertion. The record must include a sample strip with pacemaker in free running mode. 
 
3. A current cardiovascular evaluation performed by your cardiologist or internist. This evaluation must be performed after the recovery period and include: 
  •  An assessment of personal and family medical history; 
  •  A clinical cardiac and general physical examination; 
  •  Medications usage and side effects, if any; 
  • Functional capacity.

4. A report of fasting blood sugar and current blood lipid profile including total cholesterol, HDL, LDL, and triglycerides.
5. A current 24-hour ambulatory Holter monitor including representative tracings. 
6. A report of M-Mode, 2-dimensional, and Doppler echocardiogram, including film video or any other images resulting from the study. 
7. Maximal exercise treadmill stress test demonstrating functional capacity equivalent to completion of Stage III (9 minutes) of the 12-lead Bruce protocol. If beta-blockers, calcium channel blockers, or digitalis-type medications are being taken to inhibit heart rate response, it may be necessary to discontinue the drugs for 48 hours before testing in order to attain adequate heart rate. Consult with your physician before discontinuing medication. Submit report(s) and all original tracings. 
Applications for first and second-class certification will be presented to the FAA Cardiology Review Panel. 
Pacemaker dependency is determined by an unpaced resting heart rate of less than 40 beats per minute. Dependency is disqualifying for first and second-class medical certificates, but third class applicants will be considered on a case-by-case basis.


Important Note: Many pacemaker recipients are now receiving combination pacemaker/internal cardiac defibrillators on the advice or recommendation of their treating physicians. The FAA does not currently allow the use of automatic implanted cardioverter defibrillators (AICDs) for any class of medical certificate.


How and where to submit medical records to the FAA


Updated 06/13