The Canadian Cardiovascular Society “Risk of Harm” Formula and the 2003 Recommendation for LVAD Patients
Current Survival Data With LVADs
Potential for Sudden Incapacitation in LVAD-Supported Patients
Appendix I. ⁎Reproduced with permission from Elsevier from Simpson C, et al. Assessment of the cardiac patient for fitness to drive: drive subgroup executive summary. Canadian Cardiovascular Society Consensus Conference. Can J Cardiol 2004;20:1314-20. Copyright © 2004 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
Reproduced with permission from Elsevier from Simpson C, et al. Assessment of the cardiac patient for fitness to drive: drive subgroup executive summary. Canadian Cardiovascular Society Consensus Conference. Can J Cardiol 2004;20:1314-20. Copyright © 2004 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
Risk of harm formula derivation
- •Time spent behind the wheel or distance driven in a given time (TD);
- •Type of vehicle driven (V);
- •Risk of sudden cardiac incapacitation (SCI); and
- •The probability that such an event will result in a fatal or injury-producing accident (Ac).
- Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) Study Group long-term use of a left ventricular assist device for end-stage heart failure.N Engl J Med. 2001; 345: 1435-1443
- Outcomes of left ventricular assist device implantation as destination therapy in the post-REMATCH era: implications for patient selection.Circulation. 2007; 116: 497-505
- Advanced heart failure treated with continuous-flow left ventricular assist device.N Engl J Med. 2009; 361: 2241-2251
- Extended mechanical circulatory support with a continuous-flow rotary left ventricular assist device.J Am Coll Cardiol. 2009; 54: 312-321
- Continuous flow left ventricular assist device improves functional capacity and quality of life of advanced heart failure patients.J Am Coll Cardiol. 2010; 55: 1826-1834
- Second INTERMACS annual report: more than 1,000 primary left ventricular assist device implants.J Heart Lung Transplant. 2010; 29: 1-10
- Third INTERMACS annual report: the evolution of destination therapy in the United States.J Heart Lung Transplant. 2011; 30: 115-123
- Driver's education: a single center experience on the incidence and safety of driving with LVADS [abstract].J Heart Lung Transplant. 2011; 30: S70
- CMA driver's guide: determining medical fitness to operate motor vehicles.7th ed. 2006Accessed November 25, 2011)
- Assessment of the cardiac patient for fitness to drive: drive subgroup executive summary.Can J Cardiol. 2004; 20: 1314-1320
- Clinical management of continuous flow left ventricular assist devices in advanced heart failure.J Heart Lung Transplant. 2010; 29: S1-S39
- Implantable defibrillator therapy for ventricular tachyarrhythmia in left ventricular assist device patients.Eur J Heart Fail. 2010; 12: 593-599
- The 2011 Canadian Cardiovascular Society Heart Failure Management Guidelines update: Focus on sleep apnea, renal dysfunction, mechanical circulatory support, and palliative care.Can J Cardiol. 2011; 27: 319-338
This statement was developed following a thorough consideration of medical literature and the best available evidence and clinical experience. It represents the consensus of a Canadian panel comprised of multidisciplinary experts on this topic with a mandate to formulate disease-specific recommendations. These recommendations are aimed to provide a reasonable and practical approach to care for specialists and allied health professionals obliged with the duty of bestowing optimal care to patients and families, and can be subject to change as scientific knowledge and technology advance and as practice patterns evolve. The statement is not intended to be a substitute for physicians using their individual judgement in managing clinical care in consultation with the patient, with appropriate regard to all the individual circumstances of the patient, diagnostic and treatment options available and available resources. Adherence to these recommendations will not necessarily produce successful outcomes in every case.