Intraventricular conduction disturbances in civilian flying personnel: left anterior hemiblock

We undertook a retrospective study of the natural history, clinical significance, prognosis, associated conduction disturbances, and pathology, as well as flying fitness qualification of 247 cases of left anterior hemiblock (LAH), detected in a presumably healthy population of 8,915 male individuals engaged in civilian flying activities (prevalence: 2.77%). The cases were divided into three groups according to the electrical axis value of the first electrocardiogram (ECG). The group with the slow mode of appearance of LAH was the most common. If associated with right bundle branch block, LAH usually evolves first. LAH could not be ascribed to any definite pathology; neither was it a forerunner of left bundle branch block nor complete atrioventricular block. Not one episode of syncope nor of sudden incapacitation was reported. As a mere ECG finding, LAH does not modify an aviator's fitness qualification. If another conduction disturbance develops, qualification will depend on the results of complementary studies, non-invasive or invasive, according to any associated conduction disturbance.