Syncope While Driving

Abstract

As healthcare providers, our primary role is the diagnosis and management of the medical conditions of our patients. These medical conditions have an important impact on their personal lives as well as social situations. One of the most critical such interactions between a patient’s medical condition and society is syncope as it relates to driving. In our society, there is a constant conflict between the rights of the individual and the good of society. Just as limits are placed on the rights of individuals, limits are placed on the rights of society to restrict the actions of its members. Article see p 928 Syncope is an extremely common condition, accounting for 3% to 5% of the visits to emergency departments.1 There are many causes of syncope, including neurocardiogenic causes, arrhythmogenic causes, and those related to structural heart disease, among others. Although many patients never experience a recurrence, others do, and such recurrences can be extremely unpredictable. In fact, unless there is a clearly identifiable and correctable cause, when and whether a patient will have a recurrence of syncope is nearly impossible to determine. There are limited data on the causes, clinical characteristics, and predictors of syncope while driving. Nevertheless, because of the societal importance of this issue, guidelines have been written to provide recommendations to patients who have experienced syncope on the safety and timing of resumption of driving.2,3 With certain exceptions, a minimum of 6 months of abstinence from driving has been recommended after a syncopal event, with resumption of driving permitted if no further episodes have occurred. However, many of these recommendations are the consensus of experts, with very limited data on which to base the recommendations. Information on the natural history and predictors of recurrence in patients with syncope would be helpful to inform the …