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(Circulation. 2009;120:928-934.)
© 2009 American Heart Association, Inc.

Arrhythmia/Electrophysiology

Syncope While Driving

Clinical Characteristics, Causes, and Prognosis

Dan Sorajja, MD; Gillian C. Nesbitt, MD; David O. Hodge, MS; Phillip A. Low, MD; Stephen C. Hammill, MD; Bernard J. Gersh, MB, ChB, DPhil; Win-Kuang Shen, MD

From the Division of Cardiovascular Diseases (D.S., G.C.N., S.C.H., B.J.G., W.-K.S.), Division of Biostatistics (D.O.H.), and Department of Neurology (P.A.L.), Mayo Clinic, Rochester, Minn.

Reprint requests to Win-Kuang Shen, MD, Division of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 55905. E-mail wshen{at}mayo.edu

Received October 9, 2008; accepted June 30, 2009.

Background— The risk of syncope occurring while driving has obvious implications for personal and public safety. We aimed to define the clinical characteristics, causes, and prognosis of syncope while driving.

Methods and Results— In this case-control study of consecutive patients evaluated for syncope from 1996 through 1998 at an academic medical center, we documented causes, clinical characteristics, and recurrence of syncope while driving. Of 3877 patients identified, 381 (9.8%) had syncope while driving (driving group). Compared with the 3496 patients (90.2%) who did not have syncope while driving, the driving group was younger (P=0.01) and had higher percentages of male patients (P<0.001) and patients with a history of any cardiovascular disease (P=0.01) and stroke (P=0.02). Syncope while driving was commonly caused by neurally mediated syncope (37.3%) and cardiac arrhythmias (11.8%). Long-term survival in the driving group was comparable to that of an age- and sex-matched cohort from the Minnesota population (P=0.15). Among the driving group, syncope recurred in 72 patients, 35 of whom (48.6%) had recurrence >6 months after the initial evaluation. Recurrences during driving happened in 10 patients in the driving group, 7 of which (70%) were >12 months after the initial evaluation.

Conclusions— In our study, neurally mediated syncope was the most common type of syncope while driving. The causes of syncope, the late recurrences of syncope (during 6 months of follow-up), and the overall low incidence of recurrent syncope while driving provide useful information to supplement current recommendations on driving for these patients.

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CLINICAL PERSPECTIVE

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Clinical Summaries
Circulation 2009 120: 919-920. [Extract] [Full Text]

Syncope While Driving: How Safe Is Safe?

Anne B. Curtis and Andrew E. Epstein
Circulation 2009 120: 921-923. [Extract] [Full Text]

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				Syncope While Driving: Risk for Recurrence Journal Watch (General), October 6, 2009; 2009(1006): 3 - 3. [Full Text]

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