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Characteristics of US military personnel with atrial fibrillation and associated deployment and retention rates
  1. Andrea Nichole Keithler1,
  2. A S Wilson2,
  3. A Yuan2,
  4. J M Sosa2 and
  5. K Bush1
  1. 1Division of Cardiology, San Antonio Military Medical Center, Fort Sam Houston, Texas, USA
  2. 2Brooke Army Medical Center, US Army, Fort Sam Houston, Texas, USA
  1. Correspondence to Lt Col K Bush, Division of Cardiology, San Antonio Military Medical Center, Fort Sam Houston 78234, TX, USA; Kelvin.n.bush.mil{at}mail.mil

Abstract

Introduction Atrial fibrillation (AF) is an arrhythmia impacting military occupational performances. Despite being a recognised disqualifying condition, there is no literature describing US military service members with AF. This study aims to describe members with AF diagnoses, the distribution of treatment strategies and associated deployment and retention rates.

Methods Active duty service members identified with AF from 2004 to 2019 were investigated. Cardiovascular profiles, AF management strategies and military dispositions were assessed by electronic medical record review.

Results 386 service members (mean age 35.0±9.4 years; 94% paroxysmal AF) with AF diagnoses were identified. 91 (24%) had hypertension followed by 75 (19%) with sleep apnoea. Mean CHA2DS2-VASc scores were low (0.39±0.65). Rhythm treatments were used in 173 (45%) followed by rate control strategies in 155 (40%). 161 (42%) underwent pulmonary vein isolation (PVI). In subgroup analysis of 365 personnel, 147 (40%) deployed and 248 (68%) remained active duty after AF diagnosis. Deployment and retention rates did not differ between those who received no medical therapy, rate control or rhythm strategies (p=0.9039 and p=0.6192, respectively). PVI did not significantly impact deployment or retention rates (p=0.3903 and p=0.0929, respectively).

Conclusion Service members with AF are young with few AF risk factors. Rate and rhythm medical therapies were used evenly. Over two-thirds met retention standards and 40% deployed after diagnosis. There were no differences in deployment or retention between groups who receive rate therapy, rhythm medical therapy or PVI. Prospective evaluation of the efficacy of specific AF therapies on AF burden and symptomatology in service members is needed.

  • cardiology
  • adult cardiology
  • pacing & electrophysiology
  • cardiology

Data availability statement

Data are available on reasonable request. The full dataset is available from the corresponding author (andrea.n.keithler.mil@mail.mil) on request. Participant consent for data sharing was not obtained but the presented data are anonymised and risk of identification is low.

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Data availability statement

Data are available on reasonable request. The full dataset is available from the corresponding author (andrea.n.keithler.mil@mail.mil) on request. Participant consent for data sharing was not obtained but the presented data are anonymised and risk of identification is low.

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Footnotes

  • Contributors ANK, JMS and KB conceived the idea for the study and drafted the protocol. ANK, ASW, AY and JMS completed data collection. Data analysis was completed by ANK and KB. ANK and AY composed the initial manuscript draft; however, all authors provided critical feedback and contributed to the final manuscript. KB supervised the study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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