Characteristics of US military personnel with atrial fibrillation and associated deployment and retention rates.

Autor: Keithler AN; Division of Cardiology, San Antonio Military Medical Center, Fort Sam Houston, Texas, USA., Wilson AS; Department of Medicine, San Antonio Military Medical Center, Fort Sam Houston, Texas, USA., Yuan A; Division of Cardiology, San Antonio Military Medical Center, Fort Sam Houston, Texas, USA., Sosa JM; Division of Cardiology, San Antonio Military Medical Center, Fort Sam Houston, Texas, USA., Bush K; Division of Cardiology, San Antonio Military Medical Center, Fort Sam Houston, Texas, USA Kelvin.n.bush.mil@mail.mil.
Jazyk: angličtina
Zdroj: BMJ military health [BMJ Mil Health] 2023 May; Vol. 169 (e1), pp. e24-e28. Date of Electronic Publication: 2021 Mar 30.
DOI: 10.1136/bmjmilitary-2020-001665
Abstrakt: 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 CHA 2 DS 2 -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.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze: MEDLINE
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