You’re the flight surgeon at an F-16 base when a 37-yr-old male experienced command pilot presents with palpations and chest discomfort, on and off for the last week. He reports this has been a problem since he was a child. He denies any history of syncope, shortness of breath, or exercise intolerance and has never had any problems performing as an F-16 pilot. He also reports excellent +Gz tolerance in the past and his resting heart rate in clinic is 55 bpm. He has an electrocardiogram done in the clinic that is normal; however, a 7-d Holter monitor shows paroxysmal atrial fibrillation (A-fib). He is referred to Cardiology and an echocardiogram is done that shows normal structure and function; he then undergoes pulmonary vein isolation A-fib cardiac ablation. © by the Aerospace Medical Association, Alexandria, VA.