FAA AFib/A-Flutter Status Summary for Pilots

Pilots with non-valvular atrial fibrillation or atrial flutter who hold an FAA Authorization can be recertified by their AME under AASI, and this one-page status summary is the cardiologist's update for that. It covers worsening, thromboembolic history, treatment, the CHA2DS2-VASc score, emboli mitigation, a current cardiac monitor and tolerance of treatment. Any answer in the YES column means the AME must defer.

Who completes it

The treating cardiologist completes, signs and dates the summary, or writes a current, detailed clinical progress note that addresses every item. The pilot fills in name, birthdate, applicant ID and PI number.

Submitting and payment

How to submit it
The pilot returns the summary or progress note, with a current cardiac monitor report, to the AME for electronic upload to the FAA, or sends it where the Authorization letter directs.

Good to know

  • A cardiac monitor of 24 hours or longer from the last 90 days is required; submit the one-page computerized summary and representative full-scale multi-lead tracings even if normal.
  • The cardiologist addresses any average heart rate over 100, non-exertional maximum over 120 or single pause over 3 seconds.
  • With a CHA2DS2-VASc of 2 or more, the cardiologist states the emboli mitigation. Warfarin needs 6 weeks of stabilization with 80% of INRs between 2.0 and 3.0, plus the last 6 monthly values.
  • An initial AFib case is always deferred to the FAA; the AME can reissue only under a valid AASI with every answer in the left-hand column.

Get the official form

Download the current version from the source each time; forms change without notice.

Non-Valvular Atrial Fibrillation (AFib)/A-Flutter Status Summary

Fill it with Vero

If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

Can a progress note replace the FAA AFib Status Summary?

Yes. The FAA accepts a current, detailed clinical progress note from the treating cardiologist in place of the sheet, as long as it addresses every item, from worsening and thromboembolic history to CHA2DS2-VASc, emboli mitigation and monitor results. A current cardiac monitor report must accompany either one.

What cardiac monitor does the FAA want for AFib recertification?

A monitor of at least 24 hours performed within the last 90 days, with the one-page computerized summary and representative full-scale multi-lead ECG tracings, even when findings are normal. The cardiologist addresses an average rate over 100, a non-exertional maximum over 120 or any pause over 3 seconds.

When must the AME defer an AFib case?

On the initial AFib consideration, and whenever any status summary answer falls in the YES column. The AASI guidance also lists LAA occlusion or excision, a new cardiac condition, an interval thromboembolic event, poor rate control, unmitigated emboli risk and bleeding needing medical intervention.