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2625 pages added, reviewed or updated during the last month (last updated: 15/4/2021)


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implantable cardiac defibrillator and driving

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Implantable cardioverter defibrillator (ICD)

Group 1 car and motorcycle

  • In all cases of ICD implanted for sustained ventricular arrhythmia associated with incapacity, driving must stop for 6 months from the date of ICD implantation and any resumption requires:
    • the device being under regular review with interrogation
    • no other disqualifying condition
    • all the requirements as below must be met

Group 2 bus and lorry

  • ICD implantation is a permanent bar to Group 2 licensing.
  • In all cases of ICD implantation (including prophylactic ICD implantation) driving must stop permanently and:
    • the DVLA must be notified
    • the licence will be refused or revoked permanently.

ICD implanted for sustained ventricular arrhythmia associated with incapacity

Group 1 entitlement

  • Without further sequelae
    • Must not drive and must notify the DVLA.
    • Driving may resume after 6 months following implantation - except that any of the sequelae 1-4 below require further specific restrictions and may require notification to the DVLA
  • 1) With any shock therapy and/or symptomatic antitachycardia pacing (see below for therapy with incapacity)
    • Must not drive for 6 months from the time of any shock therapy and/or symptomatic anti-tachycardia pacing
    • Must notify the DVLA
    • Driving may resume after 6 months provided there is no other disqualifying condition
  • 2) With any therapy associated with incapacity (whether incapacity caused by device or arrhythmia)
    • Must not drive for 2 years after symptoms of incapacity and must notify the DVLA.
    • Exceptions to this 2 year requirement apply as follows.
      • a. If therapy delivery was due to an inappropriate cause such as atrial fibrillation or programming issues:
        • driving may resume 1 month after complete control of any cause to the satisfaction of the cardiologist. The DVLA need not be notified
      • b. If therapy delivery was appropriate due to sustained ventricular tachycardia or ventricular fibrillation, driving may resume 6 months after event:
        • provided preventive steps against recurrence have been taken with anti-arrhythmic drugs or ablation procedure, for example
        • and there is an absence of further symptomatic therapy
        • Must notify the DVLA
  • 3) With any revision of electrodes or alteration of anti-arrhythmic drug treatment
    • Must not drive for 1 month but need not notify the DVLA.
    • Driving may resume 1 month after electrode revision or drug alteration provided there is no other disqualifying condition
  • 4) With defibrillator box change
    • Must not drive for 1 week but need not notify the DVLA.
    • Driving may resume 1 week after box change provided there is no other disqualifying condition

ICD implanted for sustained ventricular arrhythmia not associated with incapacity

Group 1 entitlement

  • Must not drive for 1 month following implantation and must notify the DVLA.
  • Driving may resume 1 month after implantation provided all of the following are met:
    • presentation was a non-disqualifying cardiac event i.e.. haemodynamically stable sustained ventricular tachycardia without incapacity
    • LV ejection fraction is greater than 35%
    • any VT induced on electrophysiological study has RR interval greater than 250 milliseconds
    • during the post implantation electrophysiological study, any induced VT could be pace-terminated by the ICD twice, without acceleration
  • If any of the above not met, must not drive for 6 months following implantation
  • Note: should ICD subsequently deliver symptomatic anti-tachycardia pacing and/or shock therapy (except during normal clinical testing), the DVLA must be notified and relevant restrictions must be applied as detailed for ICD implanted for sustained ventricular arrhythmia associated with incapacity

Prophylactic ICD

Group 1 entitlement

  • In asymptomatic individuals with a high risk of significant arrhythmia
    • Must not drive for 1 month following implantation and must notify the DVLA:
      • driving may resume 1 month after implantation if remains asymptomatic and no ICD therapy needed
      • should the ICD subsequently deliver symptomatic anti-tachycardia pacing and/or shock therapy (except during normal clinical testing), the DVLA must be notified and relevant restrictions must be applied as detailed for ICD implanted for sustained ventricular arrhythmia associated with incapacity

Up-to-date guidance may be obtained from the publication "At a Glance Guide to the Current Medical Standards of Fitness to Drive" and the website www.dvla.gov.uk.

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Last edited 06/2019

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