Experiences of driving and driving restrictions in recipients with an implantable cardioverter defibrillator--the patient perspective.

BACKGROUND AND OBJECTIVES

The implantable cardioverter defibrillator (ICD) is a lifesaving device for treating patients who have experienced (secondary prevention), or are likely to experience (primary prevention), sudden cardiac death due to ventricular arrhythmias. Individuals with an ICD are prohibited from driving for a restricted period after the implantation and after recurrence of a ventricular arrhythmia, which may affect the ICD recipient in daily life. The aim of this study was therefore to describe how ICD recipients perceive driving and the driving restriction.

METHODS

Fourteen men and 6 women, aged 43 to 82 years, with driving restrictions due to both secondary and primary ICD indications, were interviewed. Data were analyzed using phenomenography.

RESULTS

The analysis resulted in the main category, the individual's unique relationship to driving, based on the categories: (1) achieving adherence on driving restrictions, (2) emotional influence of driving restriction, and (3) altered views on driving. The information was sometimes conceived as insufficient and unclear, and the willingness to accept the restriction differed. The ICD recipients perceived a loss of independence and changed self-image. Some patients had changed their driving behavior because of uncertainty of their driving abilities or fear of having arrhythmias/shocks while driving. They had different views on their future driving.

CONCLUSIONS

Handling driving restrictions after ICD implantation and shocks is a complex and delicate issue in clinical practice and should be addressed in a dialogue with the ICD recipient. More individualized and structured information and support should be given according to the ICD recipients' experiences and needs.