The FAA's "new normal" puts people at risk
Breaking down the change in electro-cardiogram standards for pilots
As reported on by Steve Kirsch in this Substack, the FAA changed its guidelines for what is healthy and normal regarding electro-cardiogram (ECG) readings. The ECG measures the nerve impulses that govern your heart-beat, and shorter and longer durations of impulse have prognostic value regarding heart health.
One of the measures with prognostic value is the PR interval, which relates to the first peak and valley which shows up on the left side of an ECG readout. A prolonged PR interval is associated with future heart problems, like atrial fibrillation, and even heart failure. The length of the PR interval is measured in milliseconds, ms.
Here is a screenshot of FAA documents back when they still had standards which matched up with the known medical risks for PR interval length (purple note added):
Risk begins to rise before you even reach 210 milliseconds for PR interval duration — as will be revealed below — and it keeps rising with every millisecond that you add. A PR interval of 200 is worse than 190, and a PR interval of 210 is even worse than 200, etc.
Now let’s looks at the FAA’s “new normal” range (purple notes added):
Lest you think that it is going to be fine for the FAA to set a new standard which is far, far beyond the 98th percentile value in reference groups who are healthy (< 220 ms), here is a bonus image for you to ponder over — but please make sure that you are sitting down when you open this link:
The FAA change is consistent with a 50% increase in atrial fibrillation
As can be seen, the original limit was set in the valley — the low point of the graph. And as can also be seen, the “new normal” is set over to the right, where risk of heart malfunction is 50% higher.
Reference
[the 98th percentile PR interval in 46,000 healthy, non-elderly people is under 220 ms] — Mason JW, Ramseth DJ, Chanter DO, Moon TE, Goodman DB, Mendzelevski B. Electrocardiographic reference ranges derived from 79,743 ambulatory subjects. J Electrocardiol. 2007 Jul;40(3):228-34. doi: 10.1016/j.jelectrocard.2006.09.003. Epub 2007 Feb 5. PMID: 17276451. https://pubmed.ncbi.nlm.nih.gov/17276451/
[graph of atrial fibrillation risk by PR interval length] — Smith JW, O'Neal WT, Shoemaker MB, Chen LY, Alonso A, Whalen SP, Soliman EZ. PR-Interval Components and Atrial Fibrillation Risk (from the Atherosclerosis Risk in Communities Study). Am J Cardiol. 2017 Feb 1;119(3):466-472. doi: 10.1016/j.amjcard.2016.10.016. Epub 2016 Nov 1. PMID: 27889043; PMCID: PMC5531862. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5531862/