Wolff-Parkinson-White (WPW)
What the FAA's documents say about wolff-Parkinson-White (WPW), in plain words, with the FAA's own words one press away.
FAA term: Wolff Parkinson White (WPW) and other pre-excitation conditions
Show the FAA's words: which classes the FAA's table covers
WOLFF PARKINSON WHITE (WPW) and other pre-excitation conditions All Classes
Short version
The FAA's table sorts it into three rows.
| Situation | What the examiner does | Pathway |
|---|---|---|
| Row AWPW pattern: an incidental ECG finding, no symptoms, never treated | Defers to the FAA | Special Issuance |
| Row BWPW syndrome treated with ablation, no medication needed | Defers to the FAA | Special Issuance |
| Row CWPW syndrome not ablated, or ablated but needing medication | Defers to the FAA | Special Issuance |
Show the FAA's words: the FAA's table for Wolff-Parkinson-White (WPW)
- Row A · Special Issuance
A WPW pattern on EKG/ECG -- an incidental finding on EKG/ECG, with no symptoms, that never required treatment. The table lists what to submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance, and summarizes findings in Item 60.
A. WPW PATTERN on EKG/ECG • Incidental finding on EKG/ECG • NO symptoms • Never required treatment Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance. Summarize findings in Item 60.
- Row B · Special Issuance
WPW syndrome treated with radiofrequency ablation, at any time in the past, that does not need antiarrhythmic medication to sustain. The table's note says not to use the typical atrial flutter page. After a 3-month recovery, the table lists what to obtain and submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance, and summarizes findings in Item 60.
B. WPW SYNDROME TREATED with radiofrequency ablation • ANY time in the past AND • Does not need antiarrhythmic medication to sustain Note: Do NOT use the typical atrial flutter page. After a 3-month recovery, obtain the following and submit for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance. Summarize findings in Item 60.
- Row C · Special Issuance
WPW syndrome (had symptoms at any time) that was not ablated, or a previous ablation but requiring medication to control rate or symptoms. The table asks for all the information in row B, and says the cardiology progress note must specifically include what it lists. The examiner defers, submits the information to the FAA for a possible Special Issuance, and summarizes findings in Item 60.
C. WPW SYNDROME (had symptoms at any time) NOT ablated OR Previous ablation but requires medication to control rate or symptoms. Submit the following for FAA review: All information in row B The cardiology progress note must specifically include: … DEFER Submit the information to the FAA for a possible Special Issuance. Summarize findings in Item 60.
- A note on the table, 1
The Item 36 Arrhythmias page has a row named Preexcitation, for all classes. It lists the CVE Protocol, a GXT and a 24-hour Holter, and says an FAA decision is required. On the FAA's page that row does not link to this table.
Item 36. Heart - Arrhythmias … Preexcitation … All … CVE Protocol ( PDF ) , GXT , and 24-hour Holter … Requires FAA Decision
- A note on the table, 2
For WPW syndrome treated with radiofrequency ablation, this table's row B says to obtain its list after a 3-month recovery and submit it for FAA review, and marks the row DEFER for a possible Special Issuance. The Item 36 Arrhythmias page also has a general Radio Frequency Ablation row, for all classes: a 3-month wait, then a 24-hour Holter; if the Holter is negative for arrhythmia, with no recurrence, Issue; otherwise an FAA decision is required. This page follows the WPW table, the specific guidance for WPW, and shows the general row as background.
B. WPW SYNDROME TREATED with radiofrequency ablation • ANY time in the past AND • Does not need antiarrhythmic medication to sustain … After a 3-month recovery, obtain the following and submit for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance.
Item 36. Heart - Arrhythmias … Radio Frequency Ablation * If performed for atrial fibrillation AFib/A-Flutter ( PDF ) , see that section first. … All … 3-month wait, then 24-hour Holter … If Holter negative for arrhythmia, no recurrence - Issue Otherwise - Requires FAA Decision
The FAA pathways for wolff-Parkinson-White (WPW)
Which one describes yours?
The FAA's table sorts it these ways. Choose yours to see its plan.
Your step-by-step plan
Step 1: The progress note
From your treating electrophysiologist or cardiologist.Progress note
Within 90 days before the examA current, detailed progress note from a clinic visit with your treating electrophysiologist or cardiologist, no more than 90 days before the exam.
It should include
- A summary of the history of the condition or diagnosis
- Current medications, dosages and side effects (if any)
- Clinical exam findings
- Results of any testing performed
- Diagnosis
- Assessment and plan (prognosis)
- Follow-up
Whether the diagnosis is WPW pattern, WPW syndrome, or other
Items your physician specifically addresses, as row A's second item lists them: whether the diagnosis is WPW pattern, WPW syndrome, or other.
Show the FAA's words: The progress note
1. A current, detailed Clinical Progress Note generated from a clinic visit with their treating electrophysiologist or cardiologist no more than 90 days before the AME exam. It should include a summary of the history of the condition or diagnosis; current medications, dosages, and side effects (if any); clinical exam findings; results of any testing performed; diagnosis; assessment and plan (prognosis); and follow-up.
FAA source: Wolff-Parkinson-White Disposition Table. FAA date 24 June 2026; checked by Crosscheck 14 October 2026.
The cardiology progress note must specifically include: • date(s) of all ablation procedure(s); • are anti-arrhythmia medications needed; • any symptoms; and • cause of recurrence/failure.
FAA source: Wolff-Parkinson-White Disposition Table. FAA date 24 June 2026; checked by Crosscheck 14 October 2026.
2. It must specifically include if the diagnosis is WPW pattern, WPW syndrome, or other.
FAA source: Wolff-Parkinson-White Disposition Table. FAA date 24 June 2026; checked by Crosscheck 14 October 2026.
“IT MUST SPECIFICALLY INCLUDE” If this language is in your letter, it is to highlight SPECIFIC items (that may or may not be part of a standard current, detailed Clinical Progress Note). Make sure your physician addresses these specific items important for medical certification or clearance.
FAA source: Pilot Information – What a Detailed Clinical Progress Note must contain. FAA date 25 September 2024; checked by Crosscheck 14 October 2026.
2. It must specifically include: • Date(s) of ablation procedure(s); • if anti-arrhythmia medications are needed; and • any continued symptoms.
FAA source: Wolff-Parkinson-White Disposition Table. FAA date 24 June 2026; checked by Crosscheck 14 October 2026.
“IT MUST SPECIFICALLY INCLUDE” If this language is in your letter, it is to highlight SPECIFIC items (that may or may not be part of a standard current, detailed Clinical Progress Note). Make sure your physician addresses these specific items important for medical certification or clearance.
FAA source: Pilot Information – What a Detailed Clinical Progress Note must contain. FAA date 25 September 2024; checked by Crosscheck 14 October 2026.
C. WPW SYNDROME (had symptoms at any time) NOT ablated OR Previous ablation but requires medication to control rate or symptoms. Submit the following for FAA review: All information in row B
FAA source: Wolff-Parkinson-White Disposition Table. FAA date 24 June 2026; checked by Crosscheck 14 October 2026.
Step 2: Heart tests
The echo, the cardiac monitor, the stress test, and other testing.Echocardiogram (echo)
Within 90 days before the examA report from a 2-D and Doppler flow study, no more than 90 days before the exam.
24-hour cardiac monitor
Within 90 days before the examA 24-hour cardiac monitor, no more than 90 days before the exam.
It should have
- Atrial and ventricular ectopic counts
- Hourly tabular data, with the longest pause duration and counts of all pauses > 2.0 or 2.5 seconds
- Heart rate (max, min and average)
- Other histograms and frequency graphs
- Percentage of atrial fibrillation/flutter
Exercise stress test (EST)
Within 90 days before the examAn exercise stress test (EST), no more than 90 days before the exam.
Other testing
Copies of any testing deemed clinically necessary by your treating physician.
Show the FAA's words: Heart tests
3. Echocardiogram (Echo). Report from a 2-D and Doppler flow study performed no more than 90 days prior to the AME exam.
FAA source: Wolff-Parkinson-White Disposition Table. FAA date 24 June 2026; checked by Crosscheck 14 October 2026.
4. 24-hour cardiac monitor performed no more than 90 days prior to the AME exam. ≥ 24-hour cardiac monitor (such as a Holter, Zio Patch, etc.). It should have atrial and ventricular ectopic counts; hourly tabular data to include the longest pause duration and counts of all pauses > 2.0 or 2.5 seconds; heart rate (max, min, and average); other histograms and frequency graphs; and percentage of atrial fibrillation/flutter.
FAA source: Wolff-Parkinson-White Disposition Table. FAA date 24 June 2026; checked by Crosscheck 14 October 2026.
4. 24-hour cardiac monitor performed at least 90 days AFTER THE ABLATION and no more than 90 days prior to the AME exam. ≥ 24-hour cardiac monitor (such as a Holter, Zio Patch, etc.). It should have atrial and ventricular ectopic counts; hourly tabular data to include the longest pause duration and counts of all pauses > 2.0 or 2.5 seconds; heart rate (max, min, and average); other histograms and frequency graphs; and percentage of atrial fibrillation/flutter.
FAA source: Wolff-Parkinson-White Disposition Table. FAA date 24 June 2026; checked by Crosscheck 14 October 2026.
5. Exercise stress test (EST) performed no more than 90 days prior to the AME exam.
FAA source: Wolff-Parkinson-White Disposition Table. FAA date 24 June 2026; checked by Crosscheck 14 October 2026.
6. Other testing. Copies of any testing deemed clinically necessary by the treating physician.
FAA source: Wolff-Parkinson-White Disposition Table. FAA date 24 June 2026; checked by Crosscheck 14 October 2026.
C. WPW SYNDROME (had symptoms at any time) NOT ablated OR Previous ablation but requires medication to control rate or symptoms. Submit the following for FAA review: All information in row B
FAA source: Wolff-Parkinson-White Disposition Table. FAA date 24 June 2026; checked by Crosscheck 14 October 2026.
Step 3: See your AME
The table lists what to submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance, and summarizes findings in Item 60.Exam day- The table lists what to submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance, and summarizes findings in Item 60.
Show the FAA's words: See your AME
A. WPW PATTERN on EKG/ECG • Incidental finding on EKG/ECG • NO symptoms • Never required treatment Submit the following for FAA review:
DEFER Submit the information to the FAA for a possible Special Issuance. Summarize findings in Item 60.
FAA source: Wolff-Parkinson-White Disposition Table. FAA date 24 June 2026; checked by Crosscheck 14 October 2026.
What the examiner checks
It depends on which row of the FAA's table describes the case.
Row ADefers to the FAASpecial Issuance
The table lists what to submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance, and summarizes findings in Item 60.
If the examiner defersRow BDefers to the FAASpecial Issuance
After a 3-month recovery, the table lists what to obtain and submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance, and summarizes findings in Item 60.
If the examiner defersRow CDefers to the FAASpecial Issuance
The table asks for all the information in row B, and says the cardiology progress note must specifically include what it lists. The examiner defers, submits the information to the FAA for a possible Special Issuance, and summarizes findings in Item 60.
If the examiner defers
Show the FAA's words: what the examiner does on each row
- Row A · Special Issuance
A WPW pattern on EKG/ECG -- an incidental finding on EKG/ECG, with no symptoms, that never required treatment. The table lists what to submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance, and summarizes findings in Item 60.
A. WPW PATTERN on EKG/ECG • Incidental finding on EKG/ECG • NO symptoms • Never required treatment Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance. Summarize findings in Item 60.
- Row B · Special Issuance
WPW syndrome treated with radiofrequency ablation, at any time in the past, that does not need antiarrhythmic medication to sustain. The table's note says not to use the typical atrial flutter page. After a 3-month recovery, the table lists what to obtain and submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance, and summarizes findings in Item 60.
B. WPW SYNDROME TREATED with radiofrequency ablation • ANY time in the past AND • Does not need antiarrhythmic medication to sustain Note: Do NOT use the typical atrial flutter page. After a 3-month recovery, obtain the following and submit for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance. Summarize findings in Item 60.
- Row C · Special Issuance
WPW syndrome (had symptoms at any time) that was not ablated, or a previous ablation but requiring medication to control rate or symptoms. The table asks for all the information in row B, and says the cardiology progress note must specifically include what it lists. The examiner defers, submits the information to the FAA for a possible Special Issuance, and summarizes findings in Item 60.
C. WPW SYNDROME (had symptoms at any time) NOT ablated OR Previous ablation but requires medication to control rate or symptoms. Submit the following for FAA review: All information in row B The cardiology progress note must specifically include: … DEFER Submit the information to the FAA for a possible Special Issuance. Summarize findings in Item 60.
If the examiner defersSpecial Issuance
The table marks row A, a WPW pattern on EKG/ECG, DEFER.
The table marks row B, WPW syndrome treated with radiofrequency ablation, DEFER.
The table marks row C, WPW syndrome not ablated or ablated but requiring medication, DEFER.
What the FAA lists to send
- Item 1. A current, detailed clinical progress note from a clinic visit with the treating electrophysiologist or cardiologist no more than 90 days before the exam, with what the table says it should include, and for row C what the cardiology progress note must specifically include.
- Item 2. An echocardiogram (echo) report from a 2-D and Doppler flow study performed no more than 90 days before the exam.
- Item 3. A 24-hour cardiac monitor performed no more than 90 days before the exam, and for row B at least 90 days after the ablation.
- Item 4. An exercise stress test (EST) performed no more than 90 days before the exam.
- Item 5. Copies of any testing deemed clinically necessary by the treating physician.
- Item 6. For row B, and for row C through all the information in row B, copies of all ablation procedure reports.
- Item 7. For rows A and B, items the physician specifically addresses, as each row's second item lists them. The FAA's progress-note sheet says that when a letter uses the words "it must specifically include", they highlight specific items (that may or may not be part of a standard current, detailed Clinical Progress Note) for the physician to address.
Show the FAA's words: if the examiner defers
When the examiner defers
- Reason 1
The table marks row A, a WPW pattern on EKG/ECG, DEFER.
A. WPW PATTERN on EKG/ECG … DEFER Submit the information to the FAA for a possible Special Issuance.
- Reason 2
The table marks row B, WPW syndrome treated with radiofrequency ablation, DEFER.
B. WPW SYNDROME TREATED with radiofrequency ablation … DEFER Submit the information to the FAA for a possible Special Issuance.
- Reason 3
The table marks row C, WPW syndrome not ablated or ablated but requiring medication, DEFER.
C. WPW SYNDROME (had symptoms at any time) NOT ablated OR Previous ablation but requires medication to control rate or symptoms. … DEFER Submit the information to the FAA for a possible Special Issuance.
What the FAA lists to send
- Item 1
A current, detailed clinical progress note from a clinic visit with the treating electrophysiologist or cardiologist no more than 90 days before the exam, with what the table says it should include, and for row C what the cardiology progress note must specifically include.
1. A current, detailed Clinical Progress Note generated from a clinic visit with their treating electrophysiologist or cardiologist no more than 90 days before the AME exam. … The cardiology progress note must specifically include:
- Item 2
An echocardiogram (echo) report from a 2-D and Doppler flow study performed no more than 90 days before the exam.
3. Echocardiogram (Echo). Report from a 2-D and Doppler flow study performed no more than 90 days prior to the AME exam.
- Item 3
A 24-hour cardiac monitor performed no more than 90 days before the exam, and for row B at least 90 days after the ablation.
4. 24-hour cardiac monitor performed no more than 90 days prior to the AME exam. … 4. 24-hour cardiac monitor performed at least 90 days AFTER THE ABLATION and no more than 90 days prior to the AME exam.
- Item 4
An exercise stress test (EST) performed no more than 90 days before the exam.
5. Exercise stress test (EST) performed no more than 90 days prior to the AME exam.
- Item 5
Copies of any testing deemed clinically necessary by the treating physician.
6. Other testing. Copies of any testing deemed clinically necessary by the treating physician.
- Item 6
For row B, and for row C through all the information in row B, copies of all ablation procedure reports.
7. Copies of all ablation procedure reports. … All information in row B
- Item 7
For rows A and B, items the physician specifically addresses, as each row's second item lists them. The FAA's progress-note sheet says that when a letter uses the words "it must specifically include", they highlight specific items (that may or may not be part of a standard current, detailed Clinical Progress Note) for the physician to address.
2. It must specifically include if the diagnosis is WPW pattern, WPW syndrome, or other. … 2. It must specifically include: • Date(s) of ablation procedure(s); • if anti-arrhythmia medications are needed; and • any continued symptoms.
“IT MUST SPECIFICALLY INCLUDE” If this language is in your letter, it is to highlight SPECIFIC items (that may or may not be part of a standard current, detailed Clinical Progress Note). Make sure your physician addresses these specific items important for medical certification or clearance.
What a Special Issuance is
The Guide says an Authorization for Special Issuance, valid for a specified period, may be granted at the Federal Air Surgeon's discretion to a person who does not meet the established medical standards, if the person shows to the satisfaction of the Federal Air Surgeon that the duties authorized by the class of certificate applied for can be performed without endangering public safety during the period the Authorization would be in force.
How the FAA pathways workGood to know
Points from the FAA's own documents that are easy to miss.
What a progress note must include
In most cases it should come from a visit with the treating physician no more than 90 days ago, and cover the history, medications with dosages and side effects, exam findings, test results, diagnosis, assessment and plan, prognosis and follow-up. The FAA's sheet says to make sure the physician adds the prognosis. A portal note or an After Visit Summary that does not meet these criteria is not enough, and neither is a simple "ok to fly" letter. The FAA's documents also call it a status report.
Show the FAA's words: good to know, 1
your patient portal to print out “notes” or an “After Visit Summary (AVS).” … Patient Portal notes or an AVS that do not meet the criteria listed below for a detailed Clinical Progress Note are NOT sufficient for FAA purposes. … To be “current,” in MOST CASES, the detailed Clinical Progress Note should be from an evaluation in which you saw your treating physician no more than 90 days ago. … It Must include the following items: … A summary of the history of the condition, … Current medications, dosages, and side effects (if any); … Clinical exam findings; … Results of any testing performed; … Diagnosis; … Assessment and Plan; … Prognosis (This item may not be on a standard progress note, make sure your physician adds this information.); and … Follow-up … Please note: A letter stating, “Mr. Smith is ok to fly” (or any other simple note), is NOT a current, detailed Clinical Progress Note and is NOT acceptable. … You may also see this called a “current status report” or “status report” in current FAA Guidance. Any reference to a “status report” equals the criteria listed on this sheet.
A WPW pattern alone is deferred
Row A, a WPW pattern found incidentally on EKG/ECG with no symptoms and never requiring treatment, lists what to submit for FAA review and is marked DEFER.
Show the FAA's words: good to know, 2
A. WPW PATTERN on EKG/ECG • Incidental finding on EKG/ECG • NO symptoms • Never required treatment Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance.
After ablation, the monitor's own timing
For row B, the table says the 24-hour cardiac monitor is performed at least 90 days after the ablation and no more than 90 days before the exam, and the list is obtained after a 3-month recovery.
Show the FAA's words: good to know, 3
After a 3-month recovery, obtain the following and submit for FAA review: … 4. 24-hour cardiac monitor performed at least 90 days AFTER THE ABLATION and no more than 90 days prior to the AME exam.
Not the typical atrial flutter page
Row B's note says not to use the typical atrial flutter page.
Show the FAA's words: good to know, 4
Note: Do NOT use the typical atrial flutter page.
Row C asks for all of row B
Row C asks for all the information in row B, and its own list for the cardiology progress note adds the cause of recurrence/failure. The table does not say how row B's ablation items apply to a pilot who was not ablated.
Show the FAA's words: good to know, 5
Submit the following for FAA review: All information in row B The cardiology progress note must specifically include: … • cause of recurrence/failure.
FAA sources
Every FAA document this page relies on, with the FAA's own date and the date Crosscheck last read it. The documents to print open at the FAA, so they are always the FAA's current ones.
- Wolff-Parkinson-White Disposition TableOpen to print: Wolff-Parkinson-White Disposition Table, a PDF at the FAA, in a new tab
Special Issuance
- Open at the FAA: Item 36 – Arrhythmias, a page at the FAA, in a new tab
- Open at the FAA: Pilot Information – What a Detailed Clinical Progress Note must contain, a PDF at the FAA, in a new tab
Related conditions
Each has its own page, with what the FAA's documents say about it.
This reports what the FAA has published. It is not medical advice, and it does not say how the FAA or an examiner will decide a case.