Cardiology>>>>>Cardiac Rehabilitation
Question 7#

When advising patients about the DVLA regulations governing the entitlement to drive a private car or motorcycle, which one of the following statements is incorrect?

A. After implantation of a standard permanent pacemaker patients may not drive for 1 week
B. After implantation of a CRT-P device patients may not drive for 1 month
C. After implantation of a prophylactic ICD patients may not drive for 1 month
D. After the initial insertion of an ICD implanted for a ventricular arrhythmia associated with incapacity, patients may not drive for 6 months
E. Patients with an ICD should stop driving for 1 month following any revision electrodes or alteration of anti-arrhythmic drug and for 1 week after a defibrillator box change

Correct Answer is B

Comment:

As with standard bradycardia pacemakers, patients who have received a CRT-P device should not drive for 1 week after implantation. Patients with an ICD implanted for a ventricular arrhythmia associated with incapacity should not drive for 6 months after the first implant, for 6 months after any shock therapy and/or symptomatic anti-tachycardia pacing, and for 2 years after any therapy accompanied by incapacity. If the shocks were due to an inappropriate cause, patients can resume driving 1 month after these problems have been resolved. If the shocks were appropriate, and appropriate steps have been taken to prevent recurrence, patients can resume driving after 6 months. Patients with an ICD implanted for a ventricular arrhythmia which did not cause incapacity can drive 1 month after ICD implantation, provided that their LVEF is >35%, no fast VT is induced on an electrophysiological study, and that any induced VT could be pace-terminated by the ICD twice, without acceleration, during the post-implantation study. Patients with an ICD should stop driving for 1 month following any revision electrodes or alteration of anti-arrhythmic drug, and for 1 week after a defibrillator box change.