title: Clinical effect of implantable cardioverter defibrillator replacements: when should you resume driving after an implantable cardioverter defibrillator replacement?
abstract: BACKGROUND
  The intervals of the driving restrictions after an implantable cardioverter defibrillator (ICD) replacement vary across the different countries around the world. However, little is known regarding the appropriate duration for driving restrictions after an ICD replacement. The aim of this study was to investigate the clinical effect of ICD replacements and to elucidate when to resume driving an automobile after an ICD replacement.
  
  
  RESULTS
  The study reviewed 139 consecutive patients with an ICD replacement in order to evaluate the incidence of ICD therapies before and after ICD replacements, and to assess the time-dependence of the ICD therapies after the ICD replacement. There was no significant difference in the incidence of ICD therapies delivered during durations of 3 months and 6 months before and after the ICD replacement (P=0.28, and 1.0, respectively). ICD therapies after the replacements were observed in 8.6% of the patients who were legally eligible to drive according to the Japanese guidelines at 1 year, and that was associated with a relatively low annual risk of death or injury to others.
  
  
  CONCLUSIONS
  Implantable cardioverter defibrillator replacements did not affect the future ICD therapies under similar algorithms. The appropriate interval for driving restrictions after an ICD replacement is recommended to be a week or so, with a system integrity check performed before resumption of driving.
authors.affiliation: Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Hiro
authors.initials: H
authors.lastname: Kawata
authors.forename: Takashi
authors.initials: T
authors.lastname: Noda
authors.forename: Takashi
authors.initials: T
authors.lastname: Kurita
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Yamagata
authors.forename: Yuko
authors.initials: Y
authors.lastname: Yamada
authors.forename: Hideo
authors.initials: H
authors.lastname: Okamura
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Satomi
authors.forename: Wataru
authors.initials: W
authors.lastname: Shimizu
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Suyama
authors.forename: Naohiko
authors.initials: N
authors.lastname: Aihara
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Isobe
authors.forename: Shiro
authors.initials: S
authors.lastname: Kamakura
mesh_terms: D000063:Accidents, Traffic / Q000331:legislation & jurisprudence / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D001334:Automobile Driving / Q000331:legislation & jurisprudence; D017147:Defibrillators, Implantable / Q000009:adverse effects; D020878:Device Removal; D004554:Electric Countershock / Q000009:adverse effects / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome