Published Online
on February 7, 2007

A more recent version of this article appeared on March 6, 2007

This Article Free upon publication Full Text (PDF) All Versions of this Article: 115/9/1170    most recent CIRCULATIONAHA.106.180203v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Epstein, A. E. Articles by Mitchell, L. B. Search for Related Content PubMed PubMed Citation Articles by Epstein, A. E. Articles by Mitchell, L. B. Pubmed/NCBI databases Medline Plus Health Information Arrhythmia Pacemakers and Implantable Defibrillators Related Collections Other Ethics and Policy Ablation/ICD/surgery Primary prevention

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Addendum to "Personal and Public Safety Issues Related to Arrhythmias That May Affect Consciousness: Implications for Regulation and Physician Recommendations: A Medical/ Scientific Statement From the American Heart Association and the North American Society of Pacing and Electrophysiology." Public Safety Issues in Patients With Implantable Defibrillators. A Scientific Statement From the American Heart Association and the Heart Rhythm Society*

Andrew E. Epstein MD, FAHA, FHRS, Christina A. Baessler RN, MSN, Anne B. Curtis MD, FAHA, FHRS, N. A. Mark Estes III MD, FAHA, FHRS, Bernard J. Gersh MB, ChB, DPhil, FAHA, Blair Grubb MD, FAHA, and L. Brent Mitchell MD, FHRS

Overview--In 1996, the American Heart Association developed a scientific statement entitled "Personal and Public Safety Issues Related to Arrhythmias That May Affect Consciousness: Implications for Regulation and Physician Recommendations." Since then, multiple trials have established the role of implantable cardioverter-defibrillators (ICDs) for the primary prevention of sudden cardiac death in patients at risk for life-threatening ventricular arrhythmias.

Objective--The issue of driving for patients with ICDs implanted for primary prevention was briefly discussed in the original statement, with the recommendation that such patients not be restricted from driving beyond the initial phase of healing. This scientific statement has been developed to extend the original 1996 recommendations and to provide specific recommendations on driving for individuals with ICDs implanted for primary prevention.

Summary of Recommendations--(1) Patients receiving ICDs for primary prevention should be restricted from driving a private automobile for at least 1 week to allow for recovery from implantation of the defibrillator. Thereafter, these driving privileges should not be restricted in the absence of symptoms potentially related to an arrhythmia. (2) Patients who have received an ICD for primary prevention who subsequently receive an appropriate therapy for ventricular tachycardia or ventricular fibrillation, especially with symptoms of cerebral hypoperfusion, should then be considered to be subject to the driving guidelines previously published for patients who received an ICD for secondary prevention. (3) Patients with ICDs for primary prevention must be instructed that impairment of consciousness is a possible future event. (4) These recommendations do not apply to the licensing of commercial drivers.

Key words: AHA Scientific Statements • prevention • defibrillation • death, sudden • arrhythmias

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