Researchers
Pietro Palmisano, Federico Guerra, Giovanni Bisignani, Giovanni Battista Forleo, Maurizio Landolina, Ezio Soldati, Giuseppe Stabile, Gabriele Zanotto, Massimo Zoni Berisso, Roberto De Ponti, Giuseppe Boriani, Renato Pietro Ricci
Abstract
In patients with cardiac implantable electronic devices (CIEDs) (implantable cardioverter-defibrillators [ICDs] and pacemakers [PMs]), the potential risk of suddenly being unable to drive, and hence of causing road accidents, is higher than in the general population. In ICD patients, this risk stems from the possibility that an arrhythmic event leading to loss of consciousness may occur while driving. In PM patients, it may be the result of a device malfunction in a PM-dependent patient. To determine a CIED patient's ability to drive, two variables must be taken into account: (i) the risk of events, which depends on the type of underlying heart disease (ICD patients have a higher risk than PM patients); (ii) the time spent driving and the type of vehicle driven (professional drivers are at higher risk than private drivers). This position paper reports the recommendations of the Italian Association of Arrhythmology and Cardiac Pacing (AIAC) regarding driving by patients with CIEDs, on the basis of the available literature and the European reference recommendations.
In recent years, the progressive aging of the population, the widening of the indications suggested by the guidelines and the increased survival of patients suffering from heart diseases are causing an exponential increase in patients with implantable electronic cardiac devices (CIED), in particular cardioverters. implantable defibrillators (ICDs) and pacemakers (PMs). The general increase in the number of implants and above all the increase in implants in patients with less advanced age (often in professional age) has had important consequences both on a practical and medico-legal level since, in addition to the undoubted clinical benefits, problems have arisen. management in the follow-up. Among these the suitability to drive motor vehicles.