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Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
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Driving restrictions for patients with reflex syncope.

Masataka Sumiyoshi1

  • 1Department of Cardiology, Juntendo University Nerima Hospital, 3-1-10 Takanodai, Nerima-ku, Tokyo 177-9521, Japan.

Journal of Arrhythmia
|December 20, 2017
PubMed
Summary

Recurrent syncope, defined as over two episodes in 5 years, may restrict driving, especially for commercial drivers. Physicians should counsel patients on driving risks and advise high-risk individuals to stop driving.

Keywords:
DrivingMotor vehicleReflex syncopeRisk of harm

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Area of Science:

  • Neurology
  • Public Health
  • Transportation Safety

Background:

  • Reflex syncope is a common cause of fainting, particularly while driving.
  • Japanese Road Traffic Laws were revised in 2014 to include stricter driving restrictions for individuals with recurrent syncope.
  • Recurrent syncope is defined as more than two episodes within a 5-year period.

Purpose of the Study:

  • To analyze driving restrictions related to recurrent syncope under Japanese law.
  • To evaluate the risk of harm associated with driving after syncope.
  • To provide guidance for physicians advising patients on driving.

Main Methods:

  • Review of Japanese Road Traffic Laws (2014 revision).
  • Definition and criteria for recurrent syncope.
  • Risk of Harm (RH) formula components: driving time, vehicle type, cardiac incapacitation risk, accident probability.

Main Results:

  • Private drivers with syncope are restricted only if it occurs without a reliable prodrome.
  • Commercial drivers with syncope are restricted unless treatment efficacy is confirmed.
  • The risk of harm (RH) is higher for commercial drivers and can be reduced by limiting driving time or vehicle weight.

Conclusions:

  • Physicians must discuss driving implications with patients experiencing syncope.
  • High-risk patients, particularly commercial drivers, should be advised to refrain from driving.
  • Legal and safety considerations necessitate careful management of driving privileges for individuals with recurrent syncope.