Cardiac conditions and the FAA's CACI program explained

You are by now probably familiar with the FAA’s CACI (conditions AMEs can issue) program that has been in effect for some time now. After the initial publication of the first batch of CACIs a couple of years ago, progress slowed a bit on getting new conditions into the pipeline. However, the FAA is moving forward with the program to remove certain conditions from the special issuance category. A new CACI worksheet for heart mitral valve repair was just published in January.

This is a good move for the FAA because cardiac conditions are new to the CACI program. The mitral valve repair—not replacement—worksheet requires five years of stability after the procedure, and requires that there have been no significant “co-morbidities” associated with the history in order for the aviation medical examiner to issue a medical certificate at the time of the FAA physical examination.

The worksheet follows the standard CACI format and includes four criteria for an office issuance. Now, the criteria are quite specific, but it’s a move in the right direction for the FAA to allow office issuances for more medical conditions that previously required a special issuance.

On a somewhat related note, I want to make you aware of a discrepancy that showed up in a previous article regarding the observation times required after cardioversion and radiofrequency ablation to treat heart arrhythmias. It was stated that both procedures require 90 days of observation before submitting records to the FAA. In fact, a cardioversion, an “electrical” procedure to convert an abnormal rhythm back into a normal rhythm, requires only a 30-day period. However, a radiofrequency ablation needs 90 days of stability. Both treatments require the same treatment and procedure records, a 24-hour Holter monitor, electrocardiogram, and a status report from the treating physician.

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Portrait of Gary Crump, AOPA's director of medical certification with a Cessna 182 Skylane at the National Aviation Community Center.
Frederick, MD USA
Gary Crump
Gary is the Director of AOPA’s Pilot Information Center Medical Certification Section and has spent the last 32 years assisting AOPA members. He is also a former Operating Room Technician, Professional Firefighter/Emergency Medical Technician, and has been a pilot since 1973.
Topics: Pilot Protection Services, AOPA Products and Services

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