Baseline factors predicting early resumption of driving after life-threatening arrhythmias in the Antiarrhythmies Versus Implantable Defibrillators (AVID) Trial

Background In the Antiarrhythmics Versus Implantable Defibrillators (AVID) Trial, patients with ventricular fibrillation or hemodynamically unstable v entricular tachycardia were randomly assigned to receive either an implanta ble cardioverter-defibrillator (]CD) or antiarrhythmic drug therapy. As par t of the trial, patients were asked to participate in a prospective driving survey. The purpose of the survey was to determine what baseline Factors a nd patient characteristics specifically predicted resumption of driving ear lier than advised by current guidelines. Methods Patients were surveyed anonymously as to their driving habits in th e initial period after random assignment and every 6 months thereafter. AVI D study coordinators were independently asked to assess their patients' dri ving status as well. The relation between baseline factors and time to resu mption of driving was explored by means of Kaplan-Meier estimates for univa riate analyses and the stepwise Cox proportional hazards regression model f or multivariate analyses. Results There were 802 patients who were eligible for assessment of driving status. The majority of patients (58%) resumed driving an automobile withi n 6 months of their index arrhythmia regardless of whether they received dr ug therapy or an ICD. By multivariate analysis, patients who were younger t han 65 years of age, mole, and college educated were more likely io drive e arly, as were patients whose index arrhythmia was ventricular tachycardia. Conclusions. Younger, college-educated men and those whose index arrhythmia is ventricular tachycardia are most likely to resume driving 16 months aft er the initiation of therapy for a potentially life-threatening ventricular arrhythmia. Patients with an ICD did not appear to resume driving later th an those who were discharged on antiarrhythmic drugs alone.