ATCO.MED.B.010 Cardiovascular system

• Regulation (EU) 2015/340 found in: Air Traffic Controllers Licensing and Certification (2015/340) Part-ATCO (Jun 2024)

ATCO.MED.B.010 Cardiovascular system Regulation (EU) 2015/340 (a)       Examination: (1)       A standard 12-lead resting electrocardiogram (ECG) and report shall be completed at the examination for the initial issue of a medical certificate and then: (i)        every 4 years until the age of 30; (ii)       at all revalidation or renewal examinations thereafter; and (iii)      when clinically indicated. (2)       An extended cardiovascular assessment shall be completed: (i)        at the first revalidation or renewal examination after the age of 65; (ii)       every 4 years thereafter; and (iii)      when clinically indicated. (3)       Estimation of serum lipids, including cholesterol, shall be required at the examination for the initial issue of a medical certificate, at the first examination after having reached the age of 40, and when clinically indicated. (b)       Cardiovascular system — General: (1)       Applicants with any of the following conditions shall be assessed as unfit: (i)        aneurysm of the thoracic or supra-renal abdominal aorta before surgery; (ii)       significant functional or symptomatic abnormality of any of the heart valves; (iii)      heart or heart/lung transplantation. (2)       Applicants with an established history or diagnosis of any of the following conditions shall be referred to the licensing authority before a fit assessment may be considered: (i)        peripheral arterial disease before or after surgery; (ii)       aneurysm of the thoracic or supra-renal abdominal aorta after surgery; (iii)      aneurysm of the infra-renal abdominal aorta before or after surgery; (iv)      functionally insignificant cardiac valvular abnormalities; (v)       after cardiac valve surgery; (vi)      abnormality of the pericardium, myocardium or endocardium; (vii)     congenital abnormality of the heart, before or after corrective surgery; (viii)    recurrent vasovagal syncope; (ix)      arterial or venous thrombosis; (x)       pulmonary embolism; (xi)      cardiovascular condition requiring systemic anticoagulant therapy. (c)       Blood pressure: (1)       Blood pressure shall be recorded at each examination. (2)       The applicant's blood pressure shall be within normal limits. (3)       Applicants shall be assessed as unfit when: (i)        they have symptomatic hypotension; or (ii)       when their blood pressure at examination consistently exceeds 160 mmHg systolic and/or 95 mmHg diastolic, with or without treatment. (4)       The initiation of medication for the control of blood pressure shall require a period of temporary unfit assessment to establish the absence of significant side effects. (d)       Coronary artery disease: (1)       Applicants with any of the following conditions shall be assessed as unfit: (i)        symptomatic coronary artery disease; (ii)       symptoms of coronary artery disease controlled by medication. (2)       Applicants with any of the following conditions shall be referred to the licensing authority and undergo cardiological evaluation to exclude myocardial ischaemia before a fit assessment may be considered: (i)        suspected myocardial ischaemia; (ii)       asymptomatic minor coronary artery disease requiring no anti-anginal treatment. (3)       Applicants with a history or diagnosis of any of the following conditions shall be referred to the licensing authority and undergo a cardiological evaluation before a fit assessment may be considered: (i)        myocardial ischaemia; (ii)       myocardial infarction; (iii)      revascularisation and stenting for coronary artery disease. (e)       Rhythm/Conduction disturbances: (1)       Applicants for a class 3 medical certificate with any significant disturbance of cardiac conduction or rhythm, intermittent or established shall be referred to the licensing authority            and undergo cardiological evaluation with satisfactory results before a fit assessment may be      considered. These disturbances shall include any of the following: (i)        disturbance of supraventricular rhythm, including intermittent or established sinoatrial dysfunction, atrial fibrillation and/or flutter and asymptomatic sinus pauses; (ii)       complete left bundle branch block; (iii)      Mobitz type 2 atrioventricular block; (iv)      broad and/or narrow complex tachycardia; (v)       ventricular pre-excitation; (vi)      asymptomatic QT prolongation; (vii)     Brugada pattern on electrocardiography. (2)       Applicants with any of the conditions listed in points (i) to (viii) may be assessed as fit in the absence of any other abnormality and subject to satisfactory cardiological evaluation: (i)        incomplete bundle branch block; (ii)       complete right bundle branch block; (iii)      stable left axis deviation; (iv)      asymptomatic sinus bradycardia; (v)       asymptomatic sinus tachycardia; (vi)      asymptomatic isolated uniform supra-ventricular or ventricular ectopic complexes; (vii)     first degree atrioventricular block; (viii)    Mobitz type 1 atrioventricular block. (3)       Applicants with a history of any of the following conditions shall be referred to the licensing authority and undergo cardiological evaluation with satisfactory results before a fit assessment may be considered: (i)        ablation therapy; (ii)       pacemaker implantation. (4)       Applicants with any of the following conditions shall be assessed as unfit: (i)        symptomatic sinoatrial disease; (ii)       complete atrioventricular block; (iii)      symptomatic QT prolongation; (iv)      an automatic implantable defibrillating system; (v)       a ventricular anti-tachycardia pacemaker.