Canadian Cardiovascular Society 2023 Guidelines on the Fitness to Drive.

Autor: Guerra PG; Université de Montréal, Institut de Cardiologie de Montréal, Montréal, Québec, Canada. Electronic address: peter.guerra@icm-mhi.org., Simpson CS; Queens University, Kingston Health Sciences Centre, Kingston, Ontario, Canada., Van Spall HGC; McMaster University, Hamilton Health Sciences Centre, Hamilton, Ontario, Canada, and Baim Institute for Clinical Research, Boston, Massachusetts, USA., Asgar AW; Université de Montréal, Institut de Cardiologie de Montréal, Montréal, Québec, Canada., Billia P; University of Toronto, University Health Network, Toronto, Ontario, Canada., Cadrin-Tourigny J; Université de Montréal, Institut de Cardiologie de Montréal, Montréal, Québec, Canada., Chakrabarti S; Division of Cardiology and Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, British Columbia, Canada., Cheung CC; Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada., Dore A; Université de Montréal, Institut de Cardiologie de Montréal, Montréal, Québec, Canada., Fordyce CB; Division of Cardiology and Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, British Columbia, Canada., Gouda P; University of Alberta, Edmonton, Alberta, Canada., Hassan A; Mitral Center of Excellence, Maine Medical Center, Portland, Maine, USA., Krahn A; Division of Cardiology and Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, British Columbia, Canada., Luc JGY; Division of Cardiology and Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, British Columbia, Canada., Mak S; University of Toronto, Sinai Health, Toronto, Ontario, Canada., McMurtry S; University of Alberta, Edmonton, Alberta, Canada., Norris C; University of Alberta, Edmonton, Alberta, Canada., Philippon F; Institut Universitaire de Cardiologie et Pneumologie de Québec, Hôpital Laval, Laval, Québec, Canada., Sapp J; Dalhousie University, QEII Health Sciences Centre, Halifax, Nova Scotia, Canada., Sheldon R; University of Calgary, Calgary, Alberta, Canada., Silversides C; University of Toronto, University Health Network, Toronto, Ontario, Canada., Steinberg C; Institut Universitaire de Cardiologie et Pneumologie de Québec, Hôpital Laval, Laval, Québec, Canada., Wood DA; Division of Cardiology and Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, British Columbia, Canada.
Jazyk: angličtina
Zdroj: The Canadian journal of cardiology [Can J Cardiol] 2024 Apr; Vol. 40 (4), pp. 500-523. Date of Electronic Publication: 2023 Oct 10.
DOI: 10.1016/j.cjca.2023.09.033
Abstrakt: Cardiovascular conditions are among the most frequent causes of impairment to drive, because they might induce unpredictable mental state alterations via diverse mechanisms like myocardial ischemia, cardiac arrhythmias, and vascular dysfunction. Accordingly, health professionals are often asked to assess patients' fitness to drive (FTD). The Canadian Cardiovascular Society previously published FTD guidelines in 2003-2004; herein, we present updated FTD guidelines. Because there are no randomized trials on FTD, observational studies were used to estimate the risk of driving impairment in each situation, and recommendations made on the basis of Canadian Cardiovascular Society Risk of Harm formula. More restrictive recommendations were made for commercial drivers, who spend longer average times behind the wheel, use larger vehicles, and might transport a larger number of passengers. We provide guidance for individuals with: (1) active coronary artery disease; (2) various forms of valvular heart disease; (3) heart failure, heart transplant, and left ventricular assist device situations; (4) arrhythmia syndromes; (5) implantable devices; (6) syncope history; and (7) congenital heart disease. We suggest appropriate waiting times after cardiac interventions or acute illnesses before driving resumption. When short-term driving cessation is recommended, recommendations are on the basis of expert consensus rather than the Risk of Harm formula because risk elevation is expected to be transient. These recommendations, although not a substitute for clinical judgement or governmental regulations, provide specialists, primary care providers, and allied health professionals with a comprehensive list of a wide range of cardiac conditions, with guidance provided on the basis of the level of risk of impairment, along with recommendations about ability to drive and the suggested duration of restrictions.
(Copyright © 2023 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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