Conti J B, Woodard D A, Tucker K J, Bryant B, King L C, Curtis A B
Department of Medicine, University of Florida, Gainesville 32610, USA.
Pacing Clin Electrophysiol. 1997 Sep;20(9 Pt 1):2200-4. doi: 10.1111/j.1540-8159.1997.tb04237.x.
Driving habits among recipients of ICDs have not been well characterized previously, yet such information may have implications for development of national policy. This study was undertaken to characterize driving behavior after defibrillator implantation in our patient population. From 1988-1993, 82 ICDs were implanted at the University of Florida. All patients received defibrillator teaching preoperatively and postoperatively with particular emphasis placed on driving restrictions. A standardized questionnaire was developed to ascertain driving behavior, compliance with restrictions, and occurrence of motor vehicle accidents following implantation. The patients were divided into two groups according to whether or not they had received a shock from their device since implantation. Group I patients did, and Group II patients did not. Fifty-two out of 82 (63%, Group I) patients had at least one shock. The remaining 30 patients had received no shocks. Mean age and gender were no different between the two groups. Mean time since implantation was 6 +/- 1.3 years in Group I, compared to 4 +/- 1.5 years in Group II (P = 0.001). Forty-seven out of 52 (90%) and 26 out of 30 (87%) in Groups I and II, respectively, resumed driving after defibrillator implantation. There was no difference in the amount of time that passed prior to resumption of driving. Group I patients drove more, 20.5 +/- 27 miles/day compared to patients in Group II, 8.3 +/- 9.7 miles/day (P = 0.02). No patient experienced device discharge during driving; likewise, no patient was involved in a motor vehicle accident secondary to their device firing. Sixty-seven out of 82 (82%) patients complied with the instructions they thought they heard; seven patients in Group I and eight patients in Group II deliberately did not follow our advice. The majority of patients do comply with physician instructions, although the instructions they remember are not always the instructions given. If a national policy is created to prohibit driving after ICD implantation, effective enforcement may be difficult.
此前，植入式心律转复除颤器（ICD）接受者的驾驶习惯尚未得到充分描述，但此类信息可能对国家政策的制定具有重要意义。本研究旨在描述我们患者群体中除颤器植入后的驾驶行为。1988年至1993年期间，佛罗里达大学共植入了82台ICD。所有患者在术前和术后均接受了除颤器相关知识培训，特别强调了驾驶限制。我们设计了一份标准化问卷，以确定植入后的驾驶行为、对限制的遵守情况以及机动车事故的发生情况。根据植入后是否接受过设备电击，将患者分为两组。第一组患者接受过电击，第二组患者未接受过电击。82名患者中有52名（63%，第一组）至少接受过一次电击。其余30名患者未接受过电击。两组患者的平均年龄和性别无差异。第一组患者植入后的平均时间为6±1.3年，第二组为4±1.5年（P = 0.001）。第一组52名患者中有47名（90%），第二组30名患者中有26名（87%）在植入除颤器后恢复了驾驶。恢复驾驶前经过的时间没有差异。第一组患者驾驶里程更多，平均每天驾驶20.5±27英里，而第二组患者平均每天驾驶8.3±9.7英里（P = 0.02）。没有患者在驾驶过程中经历设备放电；同样，也没有患者因设备触发而发生机动车事故。82名患者中有67名（82%）遵守了他们认为听到的指示；第一组有7名患者，第二组有8名患者故意未听从我们的建议。尽管大多数患者确实遵守了医生的指示，但他们记住的指示并不总是所给出的指示。如果制定一项国家政策禁止ICD植入后驾驶，有效执行可能会很困难。
