Bjerre Jenny, Rosenkranz Simone Hofman, Schou Morten, Jøns Christian, Philbert Berit Thornvig, Larroudé Charlotte, Nielsen Jens Cosedis, Johansen Jens Brock, Riahi Sam, Melchior Thomas Maria, Torp-Pedersen Christian, Hlatky Mark, Gislason Gunnar, Ruwald Anne-Christine
Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Gentofte Hospitalsvej 6, 3rd Floor, Hellerup 2900, Denmark.
Department of Cardiology, Copenhagen University Hospital Bispebjerg and Frederiksberg, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark.
Eur Heart J. 2021 Sep 14;42(35):3529-3537. doi: 10.1093/eurheartj/ehab253.
Patients are restricted from driving following implantable cardioverter defibrillator (ICD) implantation or shock. We sought to investigate how many patients are aware of, and adhere to, the driving restrictions, and what proportion experience an ICD shock or other cardiac symptoms while driving.
We performed a nationwide survey of all living Danish residents 18 years or older who received a first-time ICD between 2013 and 2016 (n = 3913) and linked their responses with nationwide registers. Of 2741 respondents (47% primary prevention, 83% male, median age 67 years), 2513 (92%) held a valid driver's license at ICD implantation, 175 (7%) of whom had a license for professional driving. Many drivers were unaware of driving restrictions: primary prevention 58%; secondary prevention 36%; post-appropriate shock 28%; professional drivers 55%. Almost all (94%) resumed non-professional driving after ICD implantation, more than one-third during the restricted period; 35% resumed professional driving. During a median follow-up of 2.3 years, 5 (0.2%) reported receiving an ICD shock while driving, one of which resulted in a traffic accident. The estimated risk of harm was 0.0002% per person-year.
In this nationwide study, many ICD patients were unaware of driving restrictions, and more than one third resumed driving during a driving restriction period. However, the rate of reported ICD shocks while driving was very low.
植入式心脏复律除颤器（ICD）植入或电击后患者会被限制驾驶。我们试图调查有多少患者知晓并遵守驾驶限制，以及有多少比例的患者在驾驶时经历ICD电击或其他心脏症状。
我们对2013年至2016年间首次植入ICD的所有18岁及以上丹麦在世居民进行了全国性调查（n = 3913），并将他们的回答与全国登记册相关联。在2741名受访者中（47%为一级预防，83%为男性，中位年龄67岁），2513人（92%）在植入ICD时有有效驾驶执照，其中175人（7%）拥有职业驾驶执照。许多驾驶员不知道驾驶限制：一级预防患者中为58%；二级预防患者中为36%；接受适当电击后为28%；职业驾驶员中为55%。几乎所有患者（94%）在植入ICD后恢复了非职业驾驶，超过三分之一是在限制期内恢复的；35%恢复了职业驾驶。在中位随访2.3年期间，5人（0.2%）报告在驾驶时接受了ICD电击，其中一次导致了交通事故。估计每人每年的伤害风险为0.0002%。
在这项全国性研究中，许多ICD患者不知道驾驶限制，超过三分之一的患者在驾驶限制期内恢复了驾驶。然而，报告的驾驶时ICD电击发生率非常低。
