[Driving of a motor vehicle after implantation of a cardioverter-defibrillator in malignant heart rhythm disorders. Criteria for the medical assessment of driving fitness in Europe].
OBJECTIVE
To investigate how medical permission to drive in patients with a cardioverter defibrillator is handled in various European countries.


METHODS
A specially developed questionnaire was sent to all 46 delegates of the pacemaker groups of the European Society of Cardiology. They were asked to provide information on the procedures and criteria used in the various countries regarding a driving ban after cardioverter defibrillator implantation (ICD).


RESULTS
39 answers (83%) were received from representatives of 24 countries. 22 (56%) of those replying advised their patients not to drive. A permanent driving ban was recommended by 13 (33%), a temporary one of 3-18 (mean 9 +/- 4) months by 26 (67%). Presyncope was named as a criterion for a ban by 15 (38%), syncope by 13 (33%) and multiple defibrillator shocks by two (5%). Contrary to medical advice not to drive about one third of patients resumed driving, half of them after 6 months. 12 months after implantation most of the patients were again driving. Defibrillator discharges occurred in 2 patients, without consequence. One patient had a fatal car accident, unrelated to loss of consciousness or defibrillator shock.


CONCLUSIONS
1. ICD discharges are an extremely rare cause of driving accidents. 2. About half of the cardiologists recommended a driving ban for a mean of 9 months after ICD. 3. Despite medical ban about half of the patients resumed driving after 6 months. 4. There are as yet no uniform criteria in Europe for judging fitness to drive.
Lüderitz
B
B
Medizinische Universitätsklinik und Poliklinik, Bonn.
Jung
W
W
D000063:Accidents, Traffic / Q000517:prevention & control; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000628:therapy*; D001334:Automobile Driving / Q000706:statistics & numerical data; D017147:Defibrillators, Implantable / Q000706:statistics & numerical data; D005060:Europe; D006801:Humans; D010809:Physical Fitness; D011795:Surveys and Questionnaires; D013997:Time Factors
Führen eines Kraftfahrzeugs nach Implantation eines Kardioverters/Defibrillators bei malignen Herzrhythmusstörungen. Kriterien zur ärztlichen Beurteilung der Fahrtüchtigkeit in Europa.