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In the absence of coronary heart disease and ischemic responses to exercise, many highly skilled pilots have been shown to have arrhythmias of non-ischemic origin. The occupational stress-exercise on a flight trainer reveals such arrhythmias much more frequently than bicycle ergometric exercise. Under social stress, namely during medical- and flying examination which decides if a pilot is professionally fit, 24-hour monitoring in the out- and inpatient settings detects premature+ ventricular contractions of non-ischemic origin in high-grade pilots; the contractions regularly decreasing or ceasing during a true flight. Thus, the social stress in pilots is a stronger arrhythmogenic factor than is the routine occupational stress.

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