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.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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