In this advisory report, a Dutch Health Council committee re-evaluates the medical fitness to drive of individuals with a so-called implantable cardioverter-defibrillator (ICD). Under current legislation, these individuals are subject to an absolute ban on driving. Since the mid-1990s, it has been stated in the scientific literature that, subject to certain conditions, some ICD recipients may be declared fit to drive a motor vehicle. The European Directive also appears to leave some scope in this respect. Based on a risk assessment and taking into account the current scope of ICD implantation, the committee concludes that two subgroups of ICD recipients may, under certain circumstances, be declared medically fit to drive and then exclusively for driving licenses falling under group 1 (light motor vehicles). Moreover, fitness to drive will, in any case, only apply following an observation period of six months after ICD implantation. The two subgroups in question are: individuals who have received an ICD for prophylactic reasons, and low-risk patients in whom an ICD has been implanted primarily for therapeutic reasons. The committee presents a proposal to amend the current legislation. (A)
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