Abstract：
Cardiovascular conditions are among the most frequent causes of impairment to drive, because they might induce unpredictable mental state alterations via diverse mechanisms like myocardial ischemia, cardiac arrhythmias, and vascular dysfunction. Accordingly, health professionals are often asked to assess patients\' fitness to drive (FTD). The Canadian Cardiovascular Society previously published FTD guidelines in 2003-2004; herein, we present updated FTD guidelines. Because there are no randomized trials on FTD, observational studies were used to estimate the risk of driving impairment in each situation, and recommendations made on the basis of Canadian Cardiovascular Society Risk of Harm formula. More restrictive recommendations were made for commercial drivers, who spend longer average times behind the wheel, use larger vehicles, and might transport a larger number of passengers. We provide guidance for individuals with: (1) active coronary artery disease; (2) various forms of valvular heart disease; (3) heart failure, heart transplant, and left ventricular assist device situations; (4) arrhythmia syndromes; (5) implantable devices; (6) syncope history; and (7) congenital heart disease. We suggest appropriate waiting times after cardiac interventions or acute illnesses before driving resumption. When short-term driving cessation is recommended, recommendations are on the basis of expert consensus rather than the Risk of Harm formula because risk elevation is expected to be transient. These recommendations, although not a substitute for clinical judgement or governmental regulations, provide specialists, primary care providers, and allied health professionals with a comprehensive list of a wide range of cardiac conditions, with guidance provided on the basis of the level of risk of impairment, along with recommendations about ability to drive and the suggested duration of restrictions.
摘要：
心血管疾病是导致驾驶障碍的最常见原因之一，因为它们可能通过心肌缺血等多种机制诱导不可预测的精神状态改变，心律失常,和血管功能障碍。因此，卫生专业人员经常被要求评估患者的驾驶适应性（FTD）。加拿大心血管学会（CCS）先前在2003-2004年发布了FTD指南；这里，我们提供最新的FTD指南。因为没有关于FTD的随机试验，观察性研究用于估计每种情况下驾驶损伤的风险，并根据CCS危害风险公式提出建议。对商业司机提出了更多限制性建议，花在方向盘后面的平均时间更长，使用更大的车辆，并可能运送更多的乘客。我们为患有1）活动性冠状动脉疾病；2）各种形式的瓣膜性心脏病；3）心力衰竭的个人提供指导，心脏移植和左心室辅助装置情况；4）心律失常综合征；5）可植入装置；6）晕厥病史；7）先天性心脏病。我们建议在心脏介入或急性疾病后再恢复驾驶之前适当的等待时间。如果建议短期停止驾驶，建议基于专家共识，而不是伤害风险公式，因为风险升高预计是短暂的。这些建议,虽然不能替代临床判断或政府法规，提供专家,初级保健提供者和专职医疗专业人员全面列出了各种心脏病，在基于减值风险水平的指导下，以及有关驾驶能力和建议的限制期限的建议。
