Cardiac driving restrictions relaxed
13 December 2002
Driving restrictions on cardiac patients have been relaxed in revised guidelines issued by the Cardiac Society of Australia and New Zealand (CSANZ).
People with automatic implantable cardioverter defibrillators were safe to hold a private driver's licence if they had not experienced discharge from the defibrillator for 6 months, the guidelines issued last week said.
(An automatic implantable cardioverter defibrillator (ICD) is a small battery-powered device that contains a tiny computer, implanted under the skin, near the collarbone. The ICD constantly monitors the heart for dangerous rhythms. If such a rhythm develops, the ICD can deliver a life-saving electrical shock. The shock returns the heart rhythm to normal.)
Previously, many people with defibrillators were not allowed to drive, guidelines co-author Dr Ken Hossack said.
The new guidelines reversed this decision, but still disallowed people with defibrillators from holding a commercial licence, he said.
They also allowed people with a history of angina to hold a commercial licence, provided they performed adequately on stress testing (9 instead of 6 minutes of exercise testing without significant ischaemia (inadequacy of blood flow to the heart muscle)) or had adequate angiography results.
People with an ejection fraction (the proportion, or fraction, of blood pumped out of the heart with each beat) greater than 40 per cent, instead of the previous 50 per cent, are also now allowed to hold commercial licences.
'For many cardiac patients, driving should not be a barrier,' Brisbane cardiologist and chair of the CSANZ's continuing education and recertification committee, Dr Hossack, said.
'Most will continue to be able to have a private licence, and many a commercial licence.'
Dr Hossack emphasised that people were fit to drive a private vehicle 2 days after uncomplicated coronary angioplasty (surgery using a balloon catheter to unblock a coronary artery) (not associated with an acute myocardial infarction (heart attack)) and 2 weeks after myocardial infarction.
But the presence of any one of a number of symptoms would see further exclusion from driving, he said.
These included angina on mild exertion, unsatisfactory performance on exercise testing, significant ECG (electrocardiograph) changes, arrhythmias (abnormal heart rhythms), poorly controlled anticoagulant ('blood thinning') therapy and hypertension (high blood pressure).
Last Reviewed: 12 December 2002
- 1. Medical Observer Weekly 13/12/02
