Driving and Implantable Cardioverter-Defibrillator Shocks for Ventricular Arrhythmias
Open accessAbstract
Objectives This study examined the risk of implantable cardioverter-defibrillator (ICD) shocks for ventricular tachycardia (VT) or ventricular fibrillation (VF) associated with driving.Background Concerns regarding VT/VF occurring during driving are the basis for driving restrictions in ICD patients; however, limited data are available to inform recommendations.Methods This study used a prospective nested case-crossover design to compare the risk of ICD shock for VT/VF both during and up to 60 min after an episode of driving as compared with that during other activities among 1,188 ICD patients enrolled in the TOVA (Triggers of Ventricular Arrhythmia) study.Results Over a median follow-up of 562 days, there were 193 ICD shocks for VT/VF with data on exposure to driving before ICD shock. The absolute risk of ICD shock for VT/VF within 1 h of driving was estimated to be 1 episode per 25,116 person-hours spent driving. The ICD shocks for VT/VF were twice as likely to occur within 1 h of driving a car as compared with other times (relative risk [RR] 2.24, 95% confidence interval [CI] 1.57 to 3.18). This risk was specific for shocks for VT/VF and occurred primarily during the 30-min period after driving (RR 4.46, 95% CI 2.92 to 6.82) rather than during the driving episode itself (RR 1.05, 95% CI 0.48 to 2.30).Conclusions Although the risk of ICD shock for VT/VF was transiently increased in the 30-min period after driving, the risk was not elevated during driving and the absolute risk was low. These data provide reassurance that driving by ICD patients should not translate into an important rate of personal or public injury.
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Driving does not appear to increase the risk of ICD shock; in the prospective case-crossover TOVA study of more than 1000 ICD patients, although there was an elevated risk of ventricular arrhythmia in the 1 hour after driving (relative risk of 2.24), there was no increased risk of arrhythmia during the driving episodes themselves.
“Driving does not appear to increase the risk of ICD shock; in the prospective case-crossover TOVA (Triggers of Ventricular Arrhythmia) study of >1000 ICD patients, although there was an elevated risk of ventricular arrhythmia in the 1 hour after driving (relative risk of 2.24), there was no increased risk of arrhythmia during the driving episodes themselves.88”
From Managing with pacemakers and implantable cardioverter defibrillators (2013) · cites this paper as [88]
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- Authors
- Albert, C. M., Rosenthal, L., Calkins, H., Steinberg, J. S., Ruskin, J. N., Wang, P., Muller, J. E., & Mittleman, M. A.
- Affiliations
- Brigham and Women's Hospital (US)
- UMass Memorial Medical Center (US)
- Johns Hopkins University (US)
- St. Luke's-Roosevelt Hospital Center (US)
- Massachusetts General Hospital (US)
- Stanford Medicine (US)
- Beth Israel Deaconess Medical Center (US)
- Corresponding author
- Albert, Christine M.
- ORCID
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2007-12
- Volume
- 50
- Issue
- 23
- Pages
- 2233-2240
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W1528538013
- Cited by
- 61
- References
- 31
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2022: 1 · 2021: 2 · 2020: 4 · 2019: 3 · 2018: 3 · 2017: 4 · 2016: 1 · 2015: 2 · 2014: 3 · 2013: 4 · 2012: 4
- FWCI
- 5.38
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Sanofi
- Boston Scientific Corporation
- St. Jude Medical
- National Heart, Lung, and Blood Institute (R01HL041016)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- implantable cardioverter-defibrillator shocks, driving, ventricular tachycardia, ventricular fibrillation, driving restrictions, ICD patients
- MeSH terms
- Aged, Automobile Driving, Electric Countershock, Female, Humans, Male, Middle Aged, Time Factors, Ventricular Fibrillation, Cohort Studies, Case-Control Studies, Defibrillators, Implantable, Tachycardia, Ventricular, Risk Assessment, Cross-Over Studies
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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