Document Detail


Driving guidelines and restrictions in patients with a history of cardiac arrhythmias, syncope,or implantable devices.
MedLine Citation:
PMID:  20842566     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OPINION STATEMENT: The need to drive is universal in many countries. Patients with syncope, cardiac arrhythmias, or implantable cardioverter-defibrillators (ICDs) have an ongoing risk of sudden incapacitation that may cause harm to themselves and/or others when driving. Restrictions on driving and driving guidelines have been developed with the intent to reduce and prevent motor vehicle accidents, thereby improving personal and public safety. Several guidelines and consensus statements recently were updated. This review focuses on the syncope-related driving guidelines and restrictions. Driving issues related to other causes of loss of consciousness, such as drug or alcohol intoxication, epilepsy, or metabolic disorders, are not included in this review. Approximately 1% to 3% of all motor vehicle accidents are caused by the driver's sudden incapacitation; of these accidents, 5% to 10% are related to cardiac causes, with or without syncope. Major cardiac causes of syncope are neurally mediated mechanisms, bradycardia, and tachycardia. When the cause of syncope is determined and adequately treated, no driving restrictions are usually required after treatment is implemented. Patients who receive ICD therapy for primary or secondary sudden cardiac death prevention are at risk for future device discharges and sudden incapacitation whether or not they are driving. When the cause of syncope is unknown, the response to treatment is uncertain (such as treating the neurocardiogenic/vasovagal syncope), or ICD discharge is possible, driving recommendations are based on the estimation of "risk of harm while driving" and the general consensus on the threshold of "acceptable risk of harm." The annual risk of harm while driving can be estimated by the following formula: driving time (%) × vehicle type (commercial to private) × annual risk of syncope or incapacitation × probability of injury or accident.
Authors:
Dan Sorajja; Win-Kuang Shen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current treatment options in cardiovascular medicine     Volume:  12     ISSN:  1534-3189     ISO Abbreviation:  Curr Treat Options Cardiovasc Med     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9815942     Medline TA:  Curr Treat Options Cardiovasc Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  443-56     Citation Subset:  -    
Affiliation:
Division of Cardiovascular Diseases, Mayo Clinic, 200 First Street Southwest, Rochester, MN, 55905, USA.
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