Table 8

Avoidance of Private Driving After an Episode of Syncope: Suggested Symptom-Free Waiting Times for Various Conditions

ConditionSymptom-Free Waiting Time
OH1 month
VVS, no syncope in prior year (382)No restriction
VVS, 1–6 syncope per year (383)1 month
VVS, >6 syncope per year (382,383)Not fit to drive until symptoms resolved
Situational syncope other than cough syncope1 month
Cough syncope, untreatedNot fit to drive
Cough syncope, treated with cough suppression1 month
Carotid sinus syncope, untreated (382)Not fit to drive
Carotid sinus syncope, treated with permanent pacemaker (382)1 week
Syncope due to nonreflex bradycardia, untreated (382)Not fit to drive
Syncope due to nonreflex bradycardia, treated with permanent pacemaker (169,382)1 week
Syncope due to SVT, untreated (382)Not fit to drive
Syncope due to SVT, pharmacologically suppressed (382)1 month
Syncope due to SVT, treated with ablation (382)1 week
Syncope with LVEF <35% and a presumed arrhythmic etiology without an ICD (384,385)Not fit to drive
Syncope with LVEF <35% and presumed arrhythmic etiology with an ICD (386,387)3 months
Syncope presumed due to VT/VF, structural heart disease and LVEF ≥35%, untreatedNot fit to drive
Syncope presumed due to VT/VF, structural heart disease and LVEF ≥35%, treated with an ICD and guideline-directed drug therapy (386,387)3 months
Syncope presumed due to VT with a genetic cause, untreatedNot fit to drive
Syncope presumed due to VT with a genetic cause, treated with an ICD or guideline-directed drug therapy3 months
Syncope presumed due to a nonstructural heart disease VT, such as RVOT or LVOT, untreatedNot fit to drive
Syncope presumed due to a nonstructural heart disease VT, such as RVOT or LVOT, treated successfully with ablation or suppressed pharmacologically (382)3 months
Syncope of undetermined etiology1 month

ICD indicates implantable cardioverter-defibrillator; LVEF, left ventricular ejection fraction; LVOT, left ventricular outflow tract; OH, orthostatic hypotension; RVOT, right ventricular outflow tract; SVT, supraventricular tachycardia; VF, ventricular fibrillation; VT, ventricular tachycardia; and VVS, vasovagal syncope.

  • It may be prudent to wait and observe for this time without a syncope spell before resuming driving.