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Johan Vijgen, Gianluca Botto, John Camm, Carl-Johan Hoijer, Werner Jung, Jean-Yves Le Heuzey, Andrzej Lubinski, Tone M Norekvål, Maurizio Santomauro, Martin Schalij, Jean-Paul Schmid, Panos Vardas, Consensus Statement: Consensus Statement of the European Heart Rhythm Association: Updated Recommendations for Driving by Patients with Implantable Cardioverter Defibrillators, European Journal of Cardiovascular Nursing, Volume 9, Issue 1, 1 March 2010, Pages 3–14, https://doi.org/10.1016/j.ejcnurse.2010.01.001
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Abstract
Patients with an implantable cardioverter defibrillator (ICD) have an ongoing risk of sudden incapacitation that might cause harm to others while driving a car. Driving restrictions vary across different countries in Europe. The most recent recommendations for driving of ICD patients in Europe were published in 1997 and focused mainly on patients implanted for secondary prevention. In recent years there has been a vast increase in the number of patients with an ICD and in the percentage of patients implanted for primary prevention. The EHRA task force on ICD and driving was formed to reassess the risk of driving for ICD patients based on the literature available. The recommendations are summarized in the following table and are further explained in the document.
| Restriction for private driving | Restriction for professional driving | |
| ICD implantation for secondary prevention | Three months | Permanent |
| ICD implantation for primary prevention | Four weeks | Permanent |
| After appropriate ICD therapy | Three months | Permanent |
| After inappropriate ICD therapy | Until measures to prevent inappropriate therapy are taken | Permanent |
| After replacement of the ICD | One week | Permanent |
| After replacement of the lead system | Four weeks | Permanent |
| Patients refusing ICD for primary prevention | No restriction | Permanent |
| Patients refusing ICD implantation for secondary prevention | Seven months | Permanent |
| Restriction for private driving | Restriction for professional driving | |
| ICD implantation for secondary prevention | Three months | Permanent |
| ICD implantation for primary prevention | Four weeks | Permanent |
| After appropriate ICD therapy | Three months | Permanent |
| After inappropriate ICD therapy | Until measures to prevent inappropriate therapy are taken | Permanent |
| After replacement of the ICD | One week | Permanent |
| After replacement of the lead system | Four weeks | Permanent |
| Patients refusing ICD for primary prevention | No restriction | Permanent |
| Patients refusing ICD implantation for secondary prevention | Seven months | Permanent |
| Restriction for private driving | Restriction for professional driving | |
| ICD implantation for secondary prevention | Three months | Permanent |
| ICD implantation for primary prevention | Four weeks | Permanent |
| After appropriate ICD therapy | Three months | Permanent |
| After inappropriate ICD therapy | Until measures to prevent inappropriate therapy are taken | Permanent |
| After replacement of the ICD | One week | Permanent |
| After replacement of the lead system | Four weeks | Permanent |
| Patients refusing ICD for primary prevention | No restriction | Permanent |
| Patients refusing ICD implantation for secondary prevention | Seven months | Permanent |
| Restriction for private driving | Restriction for professional driving | |
| ICD implantation for secondary prevention | Three months | Permanent |
| ICD implantation for primary prevention | Four weeks | Permanent |
| After appropriate ICD therapy | Three months | Permanent |
| After inappropriate ICD therapy | Until measures to prevent inappropriate therapy are taken | Permanent |
| After replacement of the ICD | One week | Permanent |
| After replacement of the lead system | Four weeks | Permanent |
| Patients refusing ICD for primary prevention | No restriction | Permanent |
| Patients refusing ICD implantation for secondary prevention | Seven months | Permanent |
Driving restrictions are perceived as difficult for patients and their families, and have an immediate consequence for their lifestyle. To increase the adherence to the driving restrictions, adequate discharge of education and follow-up of patients and family are pivotal. The task force members hope this document may serve as an instrument for European and national regulatory authorities to formulate uniform driving regulations.
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