Ventricular Arrhythmias

Ventricular arrhythmias are categorized as ventricular fibrillation and ventricular tachycardia and are responsible for the majority of instances of cardiac sudden death. Most cases are caused by coronary heart disease, but can also occur in people with hearts that are structurally normal.

Certification parameters include:

• Left ventricular ejection fraction (LVEF).
• Nonsustained ventricular tachycardia (NSVT).
• Ventricular tachycardia (VT).

See the Ventricular Arrhythmias Recommendation Table (PDF) for diagnosis-specific recommendations.

Waiting period

Minimum — 1 month after drug or other therapy and diagnosis is:

• Coronary heart disease.
• Right ventricular outflow VT.
• Idiopathic left ventricular VT.

NOTE: If more than one waiting period applies (because of multiple cardiac conditions or other comorbid diseases), examine the driver for certification after the completion of the longest waiting period.

Decision

Maximum certification period — 1 year

Recommend to certify if:

The driver:

• Is asymptomatic.
• Has an identified non-disqualifying cardiac cause.
• Has clearance from a cardiovascular specialist who understands the functions and demands of commercial driving.

Recommend not to certify if:

The driver:

• Is symptomatic.
• Has sustained VT.
• Has NSVT, LVEF less than 0.40.
• Has a diagnosis of:
  • Hypertrophic cardiomyopathy.
  • Long QT interval syndrome.
  • Brugada syndrome.

Monitoring/Testing

Have annual evaluation by a cardiovascular specialist who understands the functions and demands of commercial driving.

Follow-up

The driver should have an annual medical examination.

See the Ventricular Arrhythmias Recommendation Table (PDF) for diagnosis-specific recommendations.