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Atrial and ventricular tachyarrhythmias in military personnel
  1. Bonnie N Posselt1,
  2. A T Cox1,2,
  3. J D'Arcy1,3,
  4. M Rooms4 and
  5. M Saba4
  1. 1Defence Medical Services, Royal Centre for Defence Medicine, Birmingham, UK
  2. 2Department of Cardiology, St George's, University of London, London, UK
  3. 3Department of Cardiology, RCDM (Oxford), John Radcliffe Hospital, Oxford, UK
  4. 4Regional Occupational Health Team (North), Catterick Garrison, North Yorkshire, UK
  1. Correspondence to Flt Lt Bonnie N Posselt, RAF Henlow, Officers' Mess, Hitchin, Befordshire, SG16 6DN; bonnieposselt{at}gmail.com

Abstract

Although rare, sudden cardiac death does occur in British military personnel. In the majority of cases, the cause is considered to be a malignant ventricular tachyarrhythmia, which can be precipitated by a number of underlying pathologies. Conversely, a tachyarrhythmia may have a more benign and treatable cause, yet the initial clinical symptoms may be similar, making differentiation difficult. This is an overview of the mechanisms underlying the initiation and propagation of arrhythmias and the various pathological conditions that predispose to arrhythmia genesis, classified according to which parts of the heart are involved: atrial tachyarrhythmias, atrial and ventricular, as well as those affecting the ventricles alone. It encompasses atrial tachycardia, atrial flutter, supraventricular tachycardias and ventricular tachycardias, including the more commonly encountered inherited primary electrical diseases, also known as the channelopathies. The clinical features, investigation and management strategies are outlined. The occupational impact—in serving military personnel and potential recruits—is described, with explanations relating to the different conditions and their specific implication on continued military service.

  • OCCUPATIONAL & INDUSTRIAL MEDICINE

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