CIVIL AVIATION AUTHORITY OF NEPAL
Medical Requirements, Fourth Edition, October 2016
Nodal Rhythm
Sinus Rhythm (Atrial Rhythm)
Atrial Premature Extrasystole(s)
Nodal Premature Extrasystole(s)
Nodal Escape Beat
Atrial Escape Beat
Premature Ventricular Contraction, Unifocal, less than 30
Ventricular Escape Beat
Interpolated Extrasystoles
Ventricular Bigeminy, Trigeminy, less than 30
Ventricular Parasystole, less than 30
Terminal Intraventricular Conduction Defect
Unclassified Intraventricular Conduction Defect
Nonspecific ST elevation (Early Repolarization)
Post-extrasystolic T Wave Changes
PVC‘s (Unifocal) after Exercise
PVC‘s (Unifocal) during Exercise
S
1
, S
2
or S
1
, S
2
, S
3
Pattern
Right Bundle Branch Block (RBBB) – in absence of organic disease
Borderline i.e. Possibly Significant Abnormal Tracing, requires further evaluation
• Sinus Tachycardia – if persistent and present during basal resting state
– Med Eval, Cardiac enzymes, T3, T4 & TSH, Echocardiogram, TMT &Holter
• Paroxysmal Atrial or Nodal Tachycardia, Atrial Flutter or Atrial Fibrillation precipitated by well–
documented unusual circumstances
– Med Eval, Cardiac enzymes, T3, T4 & TSH, Echocardiogram, TMT &Holter
• First Degree A-V Block (>0.20 sec)
– Med Eval, Echocardiogram, MT &Holter
• Wenckeback (Type I A-V Block)
– Med Eval, Echocardiogram, TMT &Holter
• A-V Dissociation
– Med Eval, Echocardiogram, TMT &Holter
• Low Amplitude T Wave or Non-specific T wave Changes (in fasting condition)
– Med Eval, Echocardiogram, TMT &Holter
• Non-specific ST Depression (in fasting condition)
– Med Eval, Echocardiogram, TMT &Holter
• Abnormal TMT (1.0 mm or greater ST depression, horizontal or down sloping, of more than .08 sec
duration
– Med Eval, Echocardiogram, Holter, Thallium Scan, Coronary Amgiogram may be required
• Poor R wave Progression
– Med Eval, Echocardiogram, TMT &Holter
• PVC‘s (for the first time, over 30 years old) including Bigeminy, Trigeminy&Parasystole
– Med Eval, Echocardiogram, TMT &Holter
• Right Bundle Branch Block (RBBB) (new appearance)
– Med Eval, Echocardiogram, TMT &Holter
• Left Bundle Branch Block (LBBB) –
– Med Eval, Echocardiogram, TMT &Holter