Inappropriate implantable cardioverter defibrillator shocks—incidence, effect, and implications for driver licensing View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-09

AUTHORS

Eiichi Watanabe, Katsunori Okajima, Akira Shimane, Tomoya Ozawa, Tetsuyuki Manaka, Itsuro Morishima, Toru Asai, Masahiko Takagi, Toshihiro Honda, Atsunobu Kasai, Eitaro Fujii, Kohei Yamashiro, Ritsuko Kohno, Haruhiko Abe, Takashi Noda, Takashi Kurita, Shigeyuki Watanabe, Hiroya Ohmori, Takashi Nitta, Yoshifusa Aizawa, Ken Kiyono, Ken Okumura

ABSTRACT

PURPOSE: Patients with implantable cardioverter defibrillators (ICDs) have an ongoing risk of sudden incapacitation that may cause traffic accidents. However, there are limited data on the magnitude of this risk after inappropriate ICD therapies. We studied the rate of syncope associated with inappropriate ICD therapies to provide a scientific basis for formulating driving restrictions. METHODS: Inappropriate ICD therapy event data between 1997 and 2014 from 50 Japanese institutions were analyzed retrospectively. The annual risk of harm (RH) to others posed by a driver with an ICD was calculated for private driving habits. We used a commonly employed annual RH to others of 5 in 100,000 (0.005%) as an acceptable risk threshold. RESULTS: Of the 4089 patients, 772 inappropriate ICD therapies occurred in 417 patients (age 61 ± 15 years, 74% male, and 65% secondary prevention). Patients experiencing inappropriate therapies had a mean number of 1.8 ± 1.5 therapy episodes during a median follow-up period of 3.9 years. No significant differences were found in the age, sex, or number of inappropriate therapies between patients receiving ICDs for primary or secondary prevention. Only three patients (0.7%) experienced syncope associated with inappropriate therapies. The maximum annual RH to others after the first therapy in primary and secondary prevention patients was calculated to be 0.11 in 100,000 and 0.12 in 100,000, respectively. CONCLUSIONS: We found that the annual RH from driving was far below the commonly cited acceptable risk threshold. Our data provide useful information to supplement current recommendations on driving restrictions in ICD patients with private driving habits. More... »

PAGES

271-280

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10840-017-0272-4

DOI

http://dx.doi.org/10.1007/s10840-017-0272-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1090829319

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28730420


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