Citation

Janowski M, Chan CE, Poleszak K, Kozak M, Wysocka A, Głowniak A. Pol. Arch. Med. Wewn. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, Panstwowy Zaklad Wydawnictw Lekarskich)

DOI

10.20452/pamw.16414

PMID

36633382

Abstract

The incidence rate of syncope is 0.62% person-years [1], while that of implantable cardioverter-defibrillator (ICD) shock-associated syncope is 7% [2]. Trappe et al. observed that although 6% of ICD-implanted patients were involved in car accidents, none were attributable to ICD therapy [2]. In the AVID (Antiarrhythmics Versus Implantable Defibrillators) trial, 8% of patients had ICD interventions while driving, but those were not connected with the accidents [3]. Current limitations for patients with ICDs recommend up to 3 months of restriction post implantation/appropriate therapy for private and permanent restriction for professional drivers [4,5].

Due to scarce instances of syncope during driving, we present a case of a 77-year-old patient who has been treated for arterial hypertension, chronic coronary syndrome (two angioplasties of the left anterior descending artery in 2016 and 2019), and persistent atrial fibrillation. He had an ejection fraction of 18% and a New York Heart Association (NYHA) class II classification when a single-chamber ICD for primary prevention was implanted (February 2, 2016). On March 12, 2018, he had two episodes of ventricular fibrillation (VF); both were successfully treated by ICD. In March 2019, planned angioplasty of the left anterior descending artery was performed. His ejection fraction was 27% during post-op follow-up, although his NYHA had worsened to class III.

On December 29, 2020, the patient was involved in a fatal rear-end collision. According to the rear driver, the victim’s vehicle abruptly stopped on the road, causing the collision. The forensic pathologist’s verdict, based on the autopsy, was extensive cervical and thoracic spine trauma as the cause of death ...

Language: en