Driving restrictions in patients following syncope is difficult for physicians

Syncope occurring while driving has obvious implications for personal and public safety. In this report, the authors aimed to define the clinical characteristics, causes, and prognosis of syncope while driving. Using a case-control design, they studied consecutive patients evaluated for syncope from 1996 through 1998 at the Mayo Clinic in Rochester, Minnesota. Of 3877 patients identified, 381 (9.8%) had syncope while driving (driving group). Compared with the 3496 patients (90.2%) who did not have syncope while driving, the driving group was younger (P<0.01) and had higher percentages of male patients (P<0.001) and patients with a history of any cardiovascular disease (P<0.01) and stroke (P<0.02). Syncope while driving was commonly caused by neurally mediated syncope (37.3%) and cardiac arrhythmias (11.8%). Long-term survival in the driving group was comparable to that of an age- and sex-matched cohort from the Minnesota population. Among the driving group, syncope recurred in 72 patients, 35 of whom (48.6%) had recurrence >6 months after the initial evaluation. Recurrences during driving happened in 10 patients in the driving group, 7 of which (70%) were >12 months after the initial evaluation. Overall, neurally mediated syncope was the most common type of syncope while driving. Their findings about the late recurrences of syncope (often >6 months of follow-up) and the overall low incidence of recurrent syncope while driving, may inform future recommendations on driving for these patients.