showed that 8 out of 241 ICD patients (5%) had ICD shocks while driving but they were not associated with syncopal symptoms.
However, only a few studies have examined driving-related arrhythmias.Īn early study by Trappe et al. Such elevated sympathetic activity while driving is expected to lead to an increased propensity for arrhythmias. This study also showed that even healthy subjects have significant ST–T changes while driving. An early study showed that significant ST depression and T wave changes develop while driving in patients with ischemic heart disease. It causes an increased heart rate, blood pressure, and peripheral resistance through elevated sympathetic activity. ģ. Driving-related arrhythmias and ICD discharges while drivingĭriving brings mental and physical stress.
These data suggest that patients with syncope while driving can resume driving with a relatively low risk of harm to drivers and bystanders and. Furthermore, most of these patients with syncope while driving have had an underlying diagnosis of not arrhythmia but neurally mediated syncope. Notably, the recurrence rate of syncope while driving is only 0.7% at 6 months and 1.1% at 12 months. Among the arrhythmias in these patients, supraventricular tachycardia and VT are more frequently observed than bradycardia and. Previous observational studies reported that the most frequently identified causes are neurally mediated syncope, followed by tachycardic or bradycardic arrhythmias, and orthostatic hypotension and. Syncope while driving has evident personal and public implications, but data on the causes and outcome of syncope while driving are scarce. person-years in the Framingham study, and is often recurrent. Syncope is a common clinical problem, with an incidence rate of 6. This information is critical for the management decisions to avoid future potentially lethal incidents and unnecessary restrictions for ICD patients. We reviewed the driving restrictions of ICD patients in various regions and present a revised regulation of the Japanese driving restrictions. The cardiac implantable device committee of the Japanese Heart Rhythm Society reassessed the risk of driving in ICD patients based on the literature and domestic data.
These large varieties are due to the lack of information about the rate of syncope while driving, which results in serious harm or death in ICD patients. Many countries have regulations for driving restrictions in ICD patients, but large varieties exist between countries, ,, , and. According to literature, the rate of syncope or loss of consciousness associated with ICD therapy varies widely, ,, ,, and. The privilege of driving is cherished, but driving restrictions are necessary when it poses a threat to others. However, patients with ICDs are known to experience complete or partial loss of consciousness. Most ICD patients may be healthy enough to drive a motor vehicle. From 2006 to 2016, approximately 60,000 patients have been implanted with ICDs or CRT-Ds. The Japan Arrhythmia Device Industry Association (JADIA) reported that 57 ICDs and cardiac resynchronization therapy with defibrillators (CRT-Ds) were implanted in 20, respectively. An increasing number of patients are implanted with ICDs in Europe (EU) and the United States (US) and. Implantable cardioverter-defibrillators (ICDs) improve survival in patients who have been resuscitated from ventricular fibrillation (VF) or ventricular tachycardia (VT) (i.e., secondary prevention of sudden cardiac death) as well as primary prevention of sudden cardiac death.