Driving restrictions advised by midwestern cardiologists implanting cardioverter defibrillators: present practices, criteria utilized, and compatibility with existing state laws
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L A DiCarlo1, S A Winston, S Honoway
1Michigan Heart and Vascular Institute, Ann Arbor.
Insights
Most cardiologists implanting cardioverter defibrillators advise patients against driving post-implantation. Practices vary, with many not fully aligning with state driving laws.
Area of Science:
- Cardiology
- Medical Devices
- Public Health
Background:
- Patients with implanted cardioverter defibrillators (ICDs) for ventricular arrhythmias may face risks of syncope or collapse.
- Guidance from arrhythmia specialists on driving restrictions for ICD patients is not well-established.
Purpose of the Study:
- To survey cardiologists implanting ICDs regarding their practices for advising patients on driving restrictions.
- To assess the compatibility of these practices with existing state driving laws.
Main Methods:
- A survey was conducted among cardiologists who implant ICDs in three midwestern states.
- 51 out of 58 (88%) cardiologists responded, detailing their advice on driving restrictions and awareness of state laws.
Main Results:
- 74% of responding cardiologists advised patients against driving post-implantation, with durations ranging from 2-12 months.
- Advisory practices and duration recommendations were not uniform across practices.
- Only 53% of respondents based their advice on knowledge of state driving laws.
Conclusions:
- The majority of ICD-implanting cardiologists advise patients against driving postoperatively.
- There is significant variability in driving restriction advice and limited adherence to state driving laws among these specialists.
Abstract:
Although some patients remain at risk of losing physical control or collapsing after implantation of a cardioverter defibrillator for sustained ventricular arrhythmias, little is known about restrictions advised by arrhythmia specialists to patients with implanted devices concerning physical activities such as driving. In this study, all of the 58 cardiologists implanting cardioverter defibrillators in three contiguous midwestern states were surveyed to determine present practices and the compatibility of these practices with existing state law. Of the 51 respondents (88%), 27 cardiologists (53%) advised only those implanted patients who had had arrhythmia-induced presyncope or physical collapse to cease driving. Twenty two of the remaining cardiologists (43%) advised all implanted patients to cease driving, whereas two cardiologists (4%) never advised any implanted patient to restrict driving. Permanent driving abstinence was advised by seven of the responding cardiologists (14%), while temporary driving abstinence for periods of 2-12 months (mean 6 +/- 3 months) was recommended by the remaining 42 respondents (82%) who advised against driving. The criteria utilized, driving restrictions advised, and durations advised for driving restrictions were not uniform in any of the 13 surveyed university and nonaffiliated cardiology practices with greater than or equal to 2 implanting cardiologists. Overall, 38 cardiologists (74%) advised against driving and recommended durations that equaled or exceed their state's minimum legal requirements, although only 27 of the 51 cardiologists (53%) based their practice upon knowledge of their state's driving laws. The results of this survey suggest that the majority of cardiologists who implant cardioverter defibrillators advise their patients against driving postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)