736–1 Driving Safety in Patients with Implantable Cardioverter-Defibrillators: A Single Center Experience

There are as yet no clear guidelines regarding driving after cardioverter-defibrillator (ICD) implantation. At this Institution, depending on their mode of presentation patients (Pts) are advised to abstain from driving for 1–3 months after ICD implantation. Those without any syncopal episodes are then allowed to drive if otherwise fit. To assess the safety of this approach, we conducted a retrospective databank analysis of 635 Pts (508 males) of mean age 62.5±11.0 yrs who have been followed for a mean of 3.2±2.4 yrs (range 3 mth–12yrs). Follow-up is complete on 629 Pts. The baseline characteristics were: coronary artery disease in 80.5%, mean ejection fraction 33±14% (n=603) and 92.8% were in NYHA Class I or II. The presenting arrhythmia was unstable VT/VF in 55.5%, stable/nonsustained VT in 32.3%, and was undocumented in 12.2%. We reviewed details on all Pts who had had syncopal shocks (SS) or sudden cardiac death. There were 49 Pts who had SS; l0 of these had ≥2 SS. The mean time to first SS was 18.8±17.1 months after ICD implant. Only 1 Pt had a SS while driving (66 months after first ICD implant); this did not result in a collision. There were 127 deaths of which 22 were classified as sudden cardiac death. One Pt died suddenly while driving 3 months post implant but did not cause injury to anyone else.ConclusionIn this series, motor vehicle accidents resulting from syncopal ICD shocks or sudden death occurred rarely. These results suggest that the majority of Pts can be safely permitted to drive 1–3 months after ICD implant