Restricted driving urged for heart device patients

NEW YORK, Feb 9 (Reuters) New guidelines recommend precautionary measures when it comes to driving for people who have been given an implantable defibrillator, called an ICD.

The devices automatically deliver a shock to the heart if a dangerous irregularity in the heartbeat occurs. While this may be life-saving, it can be painful and perhaps temporarily incapacitating. Also, when an irregularity arises, there may be a decrease in consciousness before the device fires.

The guidelines, issued by the American Heart Association and the Heart Rhythm Society on Wednesday, update and expand upon driving restrictions for patients with ICDs that were mentioned briefly in early guidelines.

In 1996, the groups published an advisory that largely focused on individuals who had been given an ICD for secondary prevention of life-threatening heart-rhythm disturbances -- that is, they had already experienced such an event and were given the device to prevent another.

Since that document was released, findings from a number of studies have shown the benefit of ICDs for preventing a first cardiac event in people who are at high risk. Moreover, in 2005, Medicare began to cover ICDs for primary prevention.

In light of these developments, the two cardiology groups believed it was time to develop driving restrictions specifically for primary prevention ICD patients.

After considering data from numerous sources, the groups came up with the some driving recommendations such as: Patients given an ICD for primary prevention should not drive an automobile for at least 1 week after the procedure to allow for postoperative recovery.

If the patient gets an ICD shock to correct a rhythm irregularity, then the previously set restriction for secondary prevention should apply -- that is, no driving for 6 months after the event.

Aslo Patients given an ICD for primary prevention should be informed that impaired consciousness is now a possible future occurrence.

Lastly, these restrictions apply to private driving, not commercial driving. Federal law prohibits all patients with an ICD (for primary or secondary prevention) from being certified for commercial driving.

The updated guidelines appear in the February 7th online issue of the American Heart Association's journal Circulation.

REUTERS AKJ KP0915