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Driving and Implantable Cardioverter-Defibrillator Shocks for Ventricular Arrhythmias

Results From the TOVA Study

Christine M. Albert, MD, MPH^_*,_*, Lawrence Rosenthal, MD, Hugh Calkins, MD, Jonathan S. Steinberg, MD, Jeremy N. Ruskin, MD^||, Paul Wang, MD, MPH^¶, James E. Muller, MD, MPH^||, Murray A. Mittleman, MD, MPH^# for the TOVA Investigators

^_* Center for Arrhythmia Prevention, Division of Preventive Medicine and Cardiovascular Division, Brigham and Women’s Hospital, Boston, Massachusetts
Cardiovascular Division, University of Massachusetts Memorial Center Hospital, Worcester, Massachusetts
Cardiovascular Division, Johns Hopkins Hospital, Baltimore, Maryland
Cardiovascular Division, St. Luke’s-Roosevelt Hospital Center and Columbia University, New York, New York
^|| Cardiology Division, Massachusetts General Hospital, Boston, Massachusetts
^¶ Cardiovascular Division, Stanford University Medical Center, Stanford, California
^# Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

View larger version (14K): [in this window] [in a new window] [Download PPT slide]   Figure 1 Hazard Periods for Case-Crossover Analysis The green-shaded portion of the timeline represents the hazard period during or after a driving episode. If an implantable cardioverter-defibrillator (ICD) discharge occurred during this window, the patient was considered exposed in the primary analysis. In secondary analyses, we examined the relative risk of ICD discharge within the 3 separate shaded components of the hazard period: the period during driving (A), the first 30-min interval (B), and the second 30-min interval (C) after a driving episode.