Asymptomatic WPW, non-inducible

[Skirmisher]

After getting a flight physical done at an AF base back in march, it was discovered that I have an asymptomatic Wolff Parkinson White pattern on my EKG. I consulted the Navy aeromedical waiver guide and saw that if I have a normal echocardiogram, and if I am non-inducible during an EP study, then it is considered disqualifying/waiver recommended. Well fast-foward to now, I have had a normal echocardiogram, and I had an EP study where it was determined that I am non-inducible to a tachycardia. This was submitted to BUMED for approval and I got a waiver from them.

Now I am in the process of trying to schedule a flight physical down at Pensacola. He notified me that the NAMI liason said that many candidates with WPW were denied having a flight physical scheduled at all, despite being cleared by BUMED; thus losing their air contracts. My question is, how likely is it for me to be denied a flight physical or a NAMI waiver for my condition? And does anyone have any experience with this particular condition? I wasn't worried since the waiver guide states that my situation is CD/WR, but now that my OSO is saying people are getting turned away for this, I am a little concerned. Any input is greatly appreciated.

 

[Machine]

Similar to you, I was asymptomatic, and only found out about it during the EKG for the entrance physical. When I was at the Academy, they said I'd need to get the accessory pathway ablated if I wanted to fly, so that's what I did. Got another EPS about a year later, and my waiver was approved before I graduated. Been flying ever since.

For your personal situation, I'm not sure how they run things wrt to your air contract. I've heard of people getting royally screwed by NAMI, so if I were you, I'd try to find the right person to talk to down there.

 

[Skirmisher]

Thanks for the reply. I did not have an ablation, I was going off the waiver guide and it said I wouldn't need to if it wasn't inducible. It's interesting that you were required to do so. Hopefully that doesn't cause any problems for me. I'll probably find out in a few weeks.

 

[Camperman]

Skirmisher, how did your process go, and did you ever go for an ablation? I am considering one now. The facts as I see them-
I have not yet been ground qualified due to code
D102.95 Current unexplained ongoing or recurring cardiopulmonary symptoms - Unexplained ongoing or recurring cardiopulmonary symptoms including but not limited to chest pain, palpitations, and dyspnea on exertion that impair a physically active lifestyle

It may be an SVT remnant.
BUMED's going to take 6-8 months on my ground waiver
If I get an ablation, I may be cleared as soon as 2 months through "new data" to DoDMERB, no ground waiver necessary and skip BUMED
The waiver guide calls for a 6 month grounding period. As I'm not flying yet anyways, I think I should go ahead and 6 months from now be documentation ready for an air waiver

Does this seem stupid? Should I have any reason to wait for BUMED, figuring I'll need an air waiver anyways? Age is a factor as well, I'm nearly 30. I am aware of my PFT req's and chances at my age.

 

[Skirmisher]

Camperman, I am not a medical professional, so this is simply my own experiences and my understanding as explained by my cardiologist at the time. I did not end up getting the ablation. My cardiologist tried very aggressively during the EP study to induce a tachycardia, but he was never able to. He saw no need to ablate, and according to the waiver guide, I didn't require one. As long as I remain symptom free, I shouldn't ever require one.

At the time I was super eager to get approved right away and I made it clear to my doctor that I would prefer not to have an ablation if possible since like you said, the waiver guide calls for 6 months before being considered. It ended up taking just as long if not longer to finally get approval from BUMED anyway, so it probably wouldn't have made a difference if I had had the ablation done. It's my understanding that having one effectively 'cures' you of WPW, the accessory pathway no longer showing up on the EKG. However an ablation carries its own inherent risks. Since I was non-inducible it was determined that I will most likely never experience symptoms in my entire life, so an ablation would be riskier than doing nothing about it. If you have experienced symptoms it is my understanding that you have to have the ablation done.

If nothing has changed in the last several years, BUMED takes forever. It probably would have been nice to skip that process entirely if possible. 6-8 months sounds about right as far as how long it took me. NAMI was surprisingly easier to deal with. I was flown out to Pcola to do a flight physical and it took maybe 2-3 months before I got approval from them. It hasn't given me problems since. The only stipulation of my waiver is that I have an EKG done every year during my yearly flight physical instead of every 5 for most pilots. The WPW still shows up every time. It's a non-issue now.

 

[Camperman]

Skirmisher,

Thanks for the response! The 2011 post made me wonder if you were still active or not on these boards; I hadn't checked your profile to find out. It's encouraging to hear that being non-inducible helped your case. I've wondered about the possibility of going for the procedure, and nothing being found, how that would turn out. It might get ruled that previous episodes were panic or stress, I don't know. With nothing ever recorded for those it could go any direction.