Resumption of driving after life-threatening ventricular tachyarrhythmia.

Background: Although the privilege of driving must be respected, it may be necessary to restrict driving when it poses a threat to others. The risks a ssociated with allowing patients with life-threatening ventricular tachyarr hythmias to drive have not been quantified. Methods: The Antiarrhythmics versus Implantable Defibrillators (AVID) trial compared antiarrhythmic-drug therapy with the implantation of defibrillato rs in patients resuscitated from near-fatal ventricular arrhythmias. In the current study, we sent patients who participated in the AVID trial a quest ionnaire, to be completed anonymously, requesting information about driving habits and experiences. Results: The questionnaire was returned by 758 of 909 patients (83 percent) . Of these, 627 patients drove during the year before their index episode o f ventricular tachyarrhythmia. A total of 57 percent of these patients resu med driving within 3 months after randomization in the AVID trial, 78 perce nt within 6 months, and 88 percent within 12 months. While driving, 2 perce nt had a syncopal episode, 11 percent had dizziness or palpitations that ne cessitated stopping the vehicle, 22 percent had dizziness or palpitations t hat did not necessitate stopping the vehicle, and 8 percent of the 295 pati ents with an implantable cardioverter-defibrillator received a shock. Fifty patients reported having at least 1 accident, for a total of 55 accidents during 1619 patient-years of follow-up after the resumption of driving (3.4 percent per patient-year). Only 11 percent of these accidents were precede d by symptoms of possible arrhythmia (0.4 percent per patient-year). Conclusions: Most patients with ventricular tachyarrhythmias resume driving early. Although it is common for them to have symptoms of possible arrhyth mia while driving, accidents are uncommon and occur with a frequency that i s lower than the annual accident rate of 7.1 percent in the general driving population of the United States. (N Engl J Med 2001;345:391-7.) Copyright (C) 2001 Massachusetts Medical Society.