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; 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 Recommen- dations.” 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. (Circulation. 2007;115:1170-1176.) Key Words: AHA Scientific Statements  prevention  defibrillation  death, sudden  arrhythmias B ecause patients with arrhythmias may experience sudden impairment or loss of consciousness, 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: A Medical/Scientific State- ment From the American Heart Association and the North American Society of Pacing and Electrophysiology.” 1 In this publication, recommendations for driving were made with a focus on the treatment of patients who had survived a *The Heart Rhythm Society was formerly known as the North American Society of Pacing and Electrophysiology (NASPE). The American Heart Association and the Heart Rhythm Society make every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest. This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on October 13, 2006, and by the Heart Rhythm Society on September 22, 2006. This article has been copublished in the March 2007 issue of Heart Rhythm. Copies: A single reprint is available by calling 800-242-8721 (US only) or writing the American Heart Association, Public Information, 7272 Greenville Ave, Dallas, TX 75231-4596. Ask for reprint No. 71-0392. To purchase additional reprints: Up to 999 copies, call 800-611-6083 (US only) or fax 413-665-2671; 1000 or more copies, call 410-528-4121, fax 410-528-4264, or e-mail kelle.ramsay@wolterskluwer.com. Permissions: Multiple copies, modification, alteration, enhancement, and/or distribution of this document are not permitted without the express permission of the American Heart Association. Instructions for obtaining permission are located at http://www.americanheart.org/presenter.jhtml? Identifier=4431. A link to the “Permission Request Form” appears on the right side of the page. © 2007 American Heart Association, Inc., and the Heart Rhythm Society. Circulation is available at http://www.circulationaha.org DOI: 10.1161/CIRCULATIONAHA.106.180203 1170 AHA/HRS Scientific Statement by guest on November 6, 2015 http://circ.ahajournals.org/ Downloaded from