RESUMEN
OVERVIEW: In 1996, the American Heart Association developed a scientific statement entitled "Personal and Public Safety Issues Related to Arrhythmias That May Affect Consciousness: Implications for Regulation and Physician Recommendations." Since then, multiple trials have established the role of implantable cardioverter-defibrillators (ICDs) for the primary prevention of sudden cardiac death in patients at risk for life-threatening ventricular arrhythmias. OBJECTIVE: The issue of driving for patients with ICDs implanted for primary prevention was briefly discussed in the original statement, with the recommendation that such patients not be restricted from driving beyond the initial phase of healing. This scientific statement has been developed to extend the original 1996 recommendations and to provide specific recommendations on driving for individuals with ICDs implanted for primary prevention. SUMMARY OF RECOMMENDATIONS: (1) Patients receiving ICDs for primary prevention should be restricted from driving a private automobile for at least 1 week to allow for recovery from implantation of the defibrillator. Thereafter, these driving privileges should not be restricted in the absence of symptoms potentially related to an arrhythmia. (2) Patients who have received an ICD for primary prevention who subsequently receive an appropriate therapy for ventricular tachycardia or ventricular fibrillation, especially with symptoms of cerebral hypoperfusion, should then be considered to be subject to the driving guidelines previously published for patients who received an ICD for secondary prevention. (3) Patients with ICDs for primary prevention must be instructed that impairment of consciousness is a possible future event. (4) These recommendations do not apply to the licensing of commercial drivers.
Asunto(s)
Prevención de Accidentes/legislación & jurisprudencia , Arritmias Cardíacas/complicaciones , Conducción de Automóvil/legislación & jurisprudencia , Trastornos de la Conciencia/etiología , Desfibriladores Implantables , Arritmias Cardíacas/epidemiología , Arritmias Cardíacas/psicología , Arritmias Cardíacas/terapia , Estimulación Cardíaca Artificial , Ensayos Clínicos como Asunto/estadística & datos numéricos , Confidencialidad/ética , Trastornos de la Conciencia/prevención & control , Muerte Súbita Cardíaca/prevención & control , Desfibriladores Implantables/efectos adversos , Desfibriladores Implantables/estadística & datos numéricos , Guías como Asunto/normas , Derechos Humanos/legislación & jurisprudencia , Humanos , Concesión de Licencias/legislación & jurisprudencia , Concesión de Licencias/normas , Infarto del Miocardio/complicaciones , Autonomía Personal , Rol del Médico , Recurrencia , Riesgo , Seguridad , Síncope/etiología , Síncope/prevención & controlRESUMEN
OVERVIEW: In 1996, the American Heart Association developed a scientific statement entitled "Personal and Public Safety Issues Related to Arrhythmias That May Affect Consciousness: Implications for Regulation and Physician Recommendations." Since then, multiple trials have established the role of implantable cardioverter-defibrillators (ICDs) for the primary prevention of sudden cardiac death in patients at risk for life-threatening ventricular arrhythmias. OBJECTIVE: The issue of driving for patients with ICDs implanted for primary prevention was briefly discussed in the original statement, with the recommendation that such patients not be restricted from driving beyond the initial phase of healing. This scientific statement has been developed to extend the original 1996 recommendations and to provide specific recommendations on driving for individuals with ICDs implanted for primary prevention. SUMMARY OF RECOMMENDATIONS: (1) Patients receiving ICDs for primary prevention should be restricted from driving a private automobile for at least 1 week to allow for recovery from implantation of the defibrillator. Thereafter, these driving privileges should not be restricted in the absence of symptoms potentially related to an arrhythmia. (2) Patients who have received an ICD for primary prevention who subsequently receive an appropriate therapy for ventricular tachycardia or ventricular fibrillation, especially with symptoms of cerebral hypoperfusion, should then be considered to be subject to the driving guidelines previously published for patients who received an ICD for secondary prevention. (3) Patients with ICDs for primary prevention must be instructed that impairment of consciousness is a possible future event. (4) These recommendations do not apply to the licensing of commercial drivers.