Ablation and PVCs

F

Flyguy12345

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I fly for a living and have a PVC burden of 23-25% with no other structural heart issues. I’ve been working with AMAS and they have told me that the FAA wants to see the burden below 20%. I’ve tried diltiazem and it had no effect. I’m currently on metoprolol and waiting to get a new holter in about a week. Will the FAA really not give me their blessing with my PVC burden even though my electrophysiologist said they are completely benign and my heart is structurally strong? I wouldn’t have even known I had the PVCs if I didn’t go for my checkup due to heart issues in the family. I’m completely asymptomatic. If this round of medication doesn't work my EP said we could up the dosage or consider an ablation. Reading up on the ablation it looks like a 90 day grounding and then send in a clean holter. Assuming the operation works and gets rid of my PVCs and my holter comes back good can I return to flying status after those 90 days or would I have to wait for the FAA’s blessing? So would it be 90 days plus the additional time it takes for the FAA to look over the paperwork then give me their blessing? So I assume I’d be out for at least 6-9 months?
 
My burden was 27% and Verapamil knocked it down to 3%, so try some other medication options before ablation which brings its own risks and might not be a permanent fix. The FAA wanted mine to be below 10% even though everything else was up to spec - echo, treadmill to stage 4, benign RVOT morphology, asymptomatic, etc. My 3rd class SI approval letter included this statement:

Your heart disease places you at increased risk of in-flight cardiac impairment and sudden incapacitation when performing maneuvers involving increased G-forces. This is in addition to the baseline risk of G- induced loss of consciousness (G-LOC). For further information, please refer to FAA Advisory Circular AC - 91 - 61 which can be downloaded here: https://www.faa.gov/documentLibrary/media/Advisory_Circular/AC%2091-61.pdf​
 
forks said:
My 3rd class SI approval letter included this statement:

Your heart disease places you at increased risk of in-flight cardiac impairment and sudden incapacitation when performing maneuvers involving increased G-forces. This is in addition to the baseline risk of G- induced loss of consciousness (G-LOC). For further information, please refer to FAA Advisory Circular AC - 91 - 61 which can be downloaded here: https://www.faa.gov/documentLibrary/media/Advisory_Circular/AC%2091-61.pdf​
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I’m not going to come out and say this is horse poo, but I will say I don’t believe it without evidence. A case could be made that verapamil degrades g tolerance more than PVCs do.
 
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