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تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
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Recommendations for resuming driving after syncope

Recommendations for resuming driving after syncope
Condition Symptom-free waiting time*
OH 1 month
VVS, no syncope in prior year[1] No restriction
VVS, 1 to 6 syncope per year[2] 1 month
VVS, >6 syncope per year[1,2] Not fit to drive until symptoms resolved
Situational syncope other than cough syncope 1 month
Cough syncope, untreated Not fit to drive
Cough syncope, treated with cough suppression 1 month
Carotid sinus syncope, untreated[1] Not fit to drive
Carotid sinus syncope, treated with permanent pacemaker[1] 1 week
Syncope due to nonreflex bradycardia, untreated[1] Not fit to drive
Syncope due to nonreflex bradycardia, treated with permanent pacemaker[1,3] 1 week
Syncope due to SVT, untreated[1] Not fit to drive
Syncope due to SVT, pharmacologically suppressed[1] 1 month
Syncope due to SVT, treated with ablation[1] 1 week
Syncope with LVEF <35% and a presumed arrhythmic etiology without an ICD[4,5] Not fit to drive
Syncope with LVEF <35% and presumed arrhythmic etiology with an ICD[6,7] 3 months
Syncope presumed due to VT/VF, structural heart disease, and LVEF ≥35%, untreated Not fit to drive
Syncope presumed due to VT/VF, structural heart disease, and LVEF ≥35%, treated with an ICD and guideline-directed drug therapy[6,7] 3 months
Syncope presumed due to VT with a genetic cause, untreated Not fit to drive
Syncope presumed due to VT with a genetic cause, treated with an ICD or guideline-directed drug therapy 3 months
Syncope presumed due to a nonstructural heart disease VT, such as RVOT or LVOT, untreated Not fit to drive
Syncope presumed due to a nonstructural heart disease VT, such as RVOT or LVOT, treated successfully with ablation or suppressed pharmacologically[1] 3 months
Syncope of undetermined etiology 1 month

OH: orthostatic hypotension; VVS: vasovagal syncope; SVT: supraventricular tachycardia; LVEF: left ventricular ejection fraction; ICD: implantable cardioverter-defibrillator; VT: ventricular tachycardia; VF: ventricular fibrillation; RVOT: right ventricular outflow tract; LVOT: left ventricular outflow tract.

* It may be prudent to wait and observe for this time without a syncope spell before resuming driving.
References:
  1. Epstein AE, Miles WM, Benditt DG, et al. Personal and public safety issues related to arrhythmias that may affect consciousness: implications for regulation and physician recommendations. A medical/scientific statement from the American Heart Association and the North American Society of Pacing and Electrophysiology. Circulation 1996; 94:1147-66.
  2. Tan VH, Ritchie D, Maxey C, et al. Prospective assessment of the risk of vasovagal syncope during driving. JACC Clin Electrophysiol 2016; 2:203.
  3. Epstein AE, DiMarco JP, Ellenbogen KA, et al. 2012 ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol 2013; 61:e6.
  4. Bänsch D, Brunn J, Castrucci M, et al. Syncope in patients with an implantable cardioverter-defibrillator: incidence, prediction and implications for driving restrictions. J Am Coll Cardiol 1998; 31:608.
  5. Antonelli D, Peres D, Freedberg NA, et al. Incidence of postdischarge symptomatic paroxysmal atrial fibrillation in patients who underwent coronary artery bypass graft: long-term follow-up. Pacing Clin Electrophysiol 2004; 27:365.
  6. Thijssen J, Borleffs CJ, van Rees JB, et al. Driving restrictions after implantable cardioverter defibrillator implantation: an evidence-based approach. Eur Heart J 2011; 32:2678.
  7. Vijgen J, Botto G, Camm J, et al. Consensus statement of the European Heart Rhythm Association: updated recommendations for driving by patients with implantable cardioverter defibrillators. Europace 2009; 11:1097.

Reproduced from: Shen W-K, Sheldon RS, Benditt DG, et al. 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope. J Am Coll Cardiol 2017. Table used with the permission of Elsevier Inc. All rights reserved.

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