Pacemakers

A pacemaker is an implantable device designed to treat bradycardia. When assessing the risk for sudden, unexpected incapacitation in a driver with a pacemaker, the underlying disease responsible for the pacemaker indication must be considered.

• Both sinus node dysfunction and atrioventricular (AV) block have variable long-term prognoses, depending on the underlying disease.
• Cerebral hypoperfusion is usually corrected by support of heart rate via the implantation of a pacemaker.

Currently, pacemakers and the lead systems are reliable and durable over the long term.

Waiting period

Minimum — 1 month post-pacemaker implantation if underlying disease is:

• Sinus node dysfunction.
• AV block.

Minimum — 3 months post-pacemaker implantation if underlying disease is:

• Neurocardiogenic syncope.
• Hypersensitive carotid sinus with syncope.

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 has:

• Documentation indicating the presence of a functioning pacemaker.
• Documentation indicating completion of routine pacemaker checks.
• No disqualifying underlying disease.

Recommend not to certify if:

The driver has:

• An implantable cardiac defibrillator/pacemaker combination device.
• A disqualifying underlying disease.

Monitoring/Testing

The driver should:

• Comply with pacemaker center scheduled function checks.
• Provide documentation of pacemaker function checks at examination.

Follow-up

The driver should have an annual medical examination.

Pacemakers Recommendation Table (PDF)