3 - Cardiovascular disease and disorder - CCMTA Medical Standards

Coronary artery disease

Arrhythmias

Valvular heart disease

Cardiomyopathy

Episodic impairment: Medical assessment

Can affect Motor Sensory and Cognitive function

May also result in general debility or lack of stamina

Medical assessments

Functional Assessment

Episodic impairment: Medical assessment

Post cardiac arrest

Post-operative cognitive decline (POCD)

Can affect Motor Sensory and Cognitive function

May also result in general debility

Medical assessments

Functional Assessment

All drivers eligible for a licence if

• they meet any standards related to a specific cardiovascular condition or event

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or an
• Assessment from a cardiologist

• If the defect has been repaired and the treating physician does not indicate any concerns, no re-assessment, other than routine commercial or age-related re-assessment, is required.
• If the defect has not been repaired, RoadSafetyBC will re-assess every 5 years, unless routine commercial or age-related re-assessment applies

• Whether or not the defect has been repaired
• Presence of any specific cardiovascular condition or event or risk of condition or event that may impair functional ability to drive

Non-commercial drivers eligible for a licence if

• they have an angiographic demonstration of less than a 70% reduction in the diameter of the left main coronary artery, or
• where they have a 70% or greater reduction in the diameter of the left main coronary artery, it has been successfully treated with revascularization
• The waiting periods have been met (section 3.6.50)

• If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:
  • A Driver’s Medical Examination Report
  • Additional information from the treating physician, or
  • An assessment from a cardiologist.
• RoadSafetyBC will not generally seek angiogram studies unless there is concern from treating physician.
• RoadSafetyBC may find individuals fit to drive if
  • The applicable waiting periods are met (see 3.6.50);  OR
  • The above standard is met 

• Extent of reduction in the left main coronary artery
• Where applicable, result of treatment with revascularization
• RoadSafetyBC will not generally seek above information or angiogram studies unless there is concern from treating physician

Commercial drivers eligible for a licence if:

• They have an angiographic demonstration of less than a 50% reduction in the diameter of the left main coronary artery, or
• Where they have a 50% or greater reduction in the diameter of the left main coronary artery, it has been successfully treated with revascularization
• Providing the applicable waiting periods are met (3.6.50)

• If further information regarding an individual’s medical condition is required,  RoadSafetyBC may request:
  • A Driver’s Medical Examination Report
  • Additional information from the treating physician, or
  • An assessment from a cardiologist
• RoadSafetyBC will not generally seek angiogram studies unless there is concern from treating physician
• RoadSafetyBC may find individuals fit to drive if:
  • The applicable waiting periods are met (see 3.6.50);  OR
  • The above standard is met 

• Extent of reduction in the left main coronary artery
• Where applicable, result of treatment with revascularization
• RoadSafetyBC will not generally seek above information or angiogram studies unless there is concern from treating physician

Non-commercial drivers eligible for a licence if:

• It has been 1 month or more since CABG surgery

BC Guidelines

If further information regarding an individual’s medical condition is required, RoadSafetyBC  may request:

• A Driver’s Medical Examination Report, or additional
• Information from the treating physician

RoadSafetyBC will re-assess every five years, unless routine age-related re-assessment applies

CSS recommendations

Commercial drivers eligible for a licence if:

• It has been 3 months or more since CABG surgery

BC Guidelines

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report, or
• Additional information from the treating physician

CSS recommendations

All drivers eligible for a licence if:

• They have no associated impaired level of consciousness caused by cerebral ischemia

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or
• An assessment from a cardiologist

• If there is no underlying cardiovascular disease, no re-assessment is required, other than routine commercial or age related re-assessment
• Where there is an underlying cardiovascular disease, RoadSafetyBC will re-assess according to the guidelines for that condition

Non-commercial drivers eligible for a licence if:

• It has been 6 months or more since their last episode of ventricular fibrillation

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or
• An assessment from a cardiologist

Non-commercial drivers eligible for a licence if:

• It has been 6 months since the last episode, and
• The underlying condition has been successfully treated

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or
• An assessment from a cardiologist.

Non-commercial drivers eligible for a licence if

• it has been 3 months or more since their last episode of sustained VT

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or an assessment from a cardiologist

RoadSafetyBC may find individuals fit to drive if:

• It has been at least 3 months since their last episode, and
• If they have not been treated with an implantable cardioverter defibrillator (ICD), an assessment by a cardiologist supports driving, or if they have been treated with an ICD must meet 3.6.27 requirements

RoadSafetyBC will impose the following condition on an individual who has been treated with an ICD and is found fit to drive:

• You must report to RoadSafetyBC if you  suffer an impaired level of consciousness or disability as a result of delivery of ICD therapy

• Date of last episode of sustained VT
• Whether treated with an implantable cardioverter defibrillator (ICD)

CSS recommendations

Non-commercial drivers eligible for a licence if:

• It has been 4 weeks or more since their last episode of sustained VT, and
• They have been successfully treated with radiofrequency ablation plus a 1 week waiting period or successful pharmacological treatment

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or
• An assessment from a cardiologist

• Date of last episode of sustained VT
• Whether the driver has been successfully treated

Commercial drivers eligible for a licence if:

• It has been 3 months or more since their last episode of sustained VT, and
• They have been successfully treated with radiofrequency ablation plus a 1 week waiting period or successful pharmacological treatment

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or an assessment from a cardiologist

RoadSafetyBC will re-assess annually

• Date of last episode of sustained VT
• Whether the driver has been successfully treated

All drivers eligible for a licence if:

• They have been on medical therapy for a minimum of 3 months with no recurrence of paroxysmal SVT, AF, or AFL with impaired level of consciousness
• For drivers with paroxysmal SVT, it has been successfully treated with radiofrequency ablation
• For drivers with paroxysmal AF, they have had AV node ablation and pacemaker implantation and meet the standard for pacemaker treatment, and
• For drivers with paroxysmal AFL, they have had a successful isthmus ablation with proven establishment of bidirectional isthmus block

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or
• An assessment from a cardiologist

• Date of last occurrence of paroxysmal SVT, AF, or AFL with impaired level of consciousness
• For drivers with paroxysmal SVT, whether it has been successfully treated with radiofrequency ablation
• For drivers with paroxysmal AF, whether they have had AV node ablation and pacemaker implantation
• For drivers with paroxysmal AFL, whether they have had a successful isthmus ablation with proven establishment of bidirectional isthmus block

All drivers eligible for a licence if:

• They have adequate ventricular rate control, and
• They do not experience an impaired level of consciousness

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or
• An assessment from a cardiologist

• Whether the driver has adequate ventricular rate control
• Whether the driver experiences an impaired level of consciousness

All drivers eligible for a licence if:

• They have no associated symptoms, or
• Where they have associated symptoms, the sinus node dysfunction has been successfully treated with a pacemaker and they meet the standard for pacemaker treatment

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or
• An assessment from a cardiologist

• Whether the driver has associated symptoms
• Where the driver has associated symptoms, whether they have been successfully treated with a pacemaker

• Non-commercial drivers with:
  • Isolated first degree AV block
  • Isolated right bundle branch block (RBBB), or
  • Isolated left anterior or posterior fascicular block

are eligible for a licence

• Non-commercial drivers with:
  • Left bundle branch block (LBBB)
  • Bifascicular block
  • Second degree AV block/Mobitz I
  • First degree AV block + bifascicular block, or congenital third degree AV block

are eligible for a licence if:

• They have had no associated impaired level of consciousness

• Non-commercial drivers with
  • Second degree AV block; Mobitz II (distal AV block)
  • Alternating LBBB and RBBB, or
  • Acquired third degree AV bloc

are not eligible for a licence

BC Guidelines

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or
• An assessment from a cardiologist

• The specific nature of the atrioventricular or intraventricular block
• Where the driver has:
  • Left bundle branch block (LBBB)
  • Bifascicular block
  • Second degree AV block/Mobitz I
  • First degree AV block + bifascicular block, or
  • Congenital third degree AV block
• Whether the driver has had any associated impaired level of consciousness
• Whether a permanent pacemaker is implanted

• Commercial drivers with:
  • Isolated first degree AV block
  • Isolated right bundle branch block (RBBB), or
  • Isolated left anterior or posterior fascicular block

are eligible for a licence

• Commercial drivers with
  • Left bundle branch block (LBBB)
  • Bifascicular block
  • Second degree AV block/Mobitz I, or
  • First degree AV block + bifascicular block 

are eligible for a licence if

• They have had no associated impaired level of consciousness, and
• The conditions for maintaining a licence are met

• Commercial drivers with a congenital third degree AV block are eligible for a licence if:
  • They have had no associated impaired level of consciousness
  • They have a QRS duration < 110 msec, and
  • They have a Holter showing no documented pauses > 3 seconds
  • The conditions for maintaining a licence are met

• Commercial drivers with:
  • Second degree AV block; Mobitz II (distal AV block)
  • Alternating LBBB and RBBB, or
  • Acquired third degree AV block

are not eligible for a licence

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or
• An assessment from a cardiologist

Drivers with:

• Left bundle branch block (LBBB)
• Bifascular block
• Second degree AV block/Mobitz I, or 
• First degree AV block + bifascular block

have an annual Holter that shows there is no higher grade AV block.

Drivers with a congenital third degree AV block have an annual Hotler that shows no documented pause > 3 seconds

• The specific nature of the atrioventricular or intraventricular block
• Where the driver has:
  • Left bundle branch block (LBBB)
  • ZBifascicular block
  • Second degree AV block/Mobitz I
  • First degree AV block + bifascicular block, or
  • Congenital third degree AV block
• Whether the driver has had any associated impaired level of consciousness and the results of Holter confirming no higher grade AV block
• Where the driver has had congenital third degree AV block, whether they have a QRS duration <110 msec and the results of a Holter showing no documented pauses >3 seconds

Non-commercial drivers eligible for a licence if:

• It has been 1 week or more since pacemaker implant
• They have not experienced any episodes of impaired level or consciousness since the implant
• They show normal sensing and capture on a post-implant ECG, and
• The conditions for maintaining a licence are met

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or
• An assessment from a cardiologist

• Whether the driver has experienced any episodes of impaired level of consciousness since the implant
• Whether the results of a post-implant ECG show normal sensing and capture

Commercial drivers eligible for a licence if:

• It has been 1 month or more since pacemaker implant
• They have not experienced any episodes of impaired level of consciousness since the implant
• They show normal sensing and capture on a post-implant ECG, and
• The conditions for maintaining a licence are met

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or
• An assessment from a cardiologist

Regularly check pacemaker at a pacemaker clinic and do not driver if there is a pacemaker malfunction

• Date of pacemaker implant
• Whether the driver has experienced any episodes of impaired level of consciousness since the implant
• Whether the results of a post-implant ECG show normal sensing and capture

Non-commercial drivers eligible for a licence if:

• They are assessed as NYHA Class I, II, or III
• It has been 4 weeks or more since ICD implant (if applicable), and
• The conditions for maintaining a licence are met (if applicable)

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or
• An assessment from a cardiologist

• Regularly check ICD at a device clinic and do not drive if there is an ICD malfunction
• Report to the authority if you experience an impaired level of consciousness or disability as a result of ICD therapy

If the individual’s condition is controlled and stable, RoadSafetyBC will re-assess every five years, unless a shorter period is recommended by the treating physician or routine age-related re-assessment applies

• NYHA classification
• Date of ICD implant (if applicable)

Commercial drivers generally not eligible for a licence. May be eligible if:

• Cardiologist assessment indicates that the annual risk of sudden incapacitation is 1% or less, and
• The driver meets the standard for ICD implanted as a primary prophylaxis in non-commercial drivers 3.6.25

Non-commercial drivers eligible for a licence:

• If they are assessed as NYHA Class I, II, or III
• It has been 1 week or more since ICD implant
• It has been 3 months or more since their last episode of sustained VT, and
• The conditions for maintaining a licence are met

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or an assessment from a cardiologist

• Regularly check ICD at a device clinic and do not drive if there is an ICD malfunction
• Report to the authority if you experience an impaired level of consciousness or disability as a result of ICD therapy

• NYHA classification
• Date of ICD implant
• Date of last episode of sustained VT
• Had driver experienced an impaired level of consciousness since ICD implant

Non-commercial drivers eligible for a licence if:

• It has been 6 months or more since the event, and
• The standard for the underlying cardiovascular condition are met

Non-commercial drivers eligible for a licence if:

• It has been 6 months or more since the event, and
• The standard for the underlying cardiovascular condition are met

Commercial drivers generally not eligible for a licence. May be eligible if cardiologist assessment indicates that the annual risk of sudden incapacitation is 1% or less.

Non-commercial drivers eligible for a licence:

• If assessed as NYHA class I, II, III
• It has been 6 months or more since their last episode of sustained symptomatic VT or syncope judged to be likely due to VT or cardiac arrest, and
• The conditions for maintaining a licence are met

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or
• An assessment from a cardiologist

• Regularly check ICD at a device clinic and do not drive if there is an ICD malfunction
• Report to the authority if you experience an impaired level of consciousness or disability as a result of ICD therapy

If the individual’s condition is controlled and stable, RoadSafetyBC will re-assess every five years, unless a shorter period is recommended by the treating physician or routine age-related re-assessment applies

Commercial drivers generally not eligible for a licence. May be eligible if cardiologist assessment indicates that the annual risk of sudden incapacitation is 1% or less.

Non-Commercial drivers eligible for a licence if:

• Their condition has been investigated and treated by a cardiologist, and
• It has been 6 months or more since they have experienced any event causing an impaired level of consciousness

• Confirmation that the condition has been investigated and treated by a cardiologist
• Date of last event causing an impaired level of consciousness (if applicable)

Commercial drivers generally not eligible for a licence. May be eligible if:

• An assessment by a cardiologist indicates that the annual risk of sudden incapacitation is 1% or less, and
• The driver meets the standard for inherited heart disease in non-commercial drivers

Non-commercial drivers eligible for a licence if:

• They are assessed as NYHA Class I or II, and
• They have had no episodes of impaired level of consciousness

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or
• An assessment from a cardiologist

RoadSafetyBC will re-assess every five years, unless routine age-related re-assessment applies

• NYHA classification
• Whether the driver has had an episode of impaired level of consciousness

Commercial drivers eligible for a licence if:

• They are assessed as NYHA Class I
• Their condition is asymptomatic
• They have an aortic valve area (AVA) ) > 1.0 cm2
• They have a left ventricle ejection fraction (LVEF) of equal or greater than 35%
• They have had a detailed assessment by a cardiologist, including an assessment for risk of syncope, and
• The conditions for maintaining a licence are met

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or
• An assessment from a cardiologist

RoadSafetyBC will re-assess annually

• NYHA classification
• Whether condition is asymptomatic
• Aortic Valve Area (AVA)
• Left ventricle ejection fraction (LVEF)
• Confirmation of cardiologist assessment including risk of syncope

Commercial drivers eligible for a licence if:

• They are assessed as NYHA Class I
• They have a left ventricle ejection fraction (LVEF) equal or greater than 35%
• They have had no episodes of impaired level of consciousness

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or
• An assessment from a cardiologist

RoadSafetyBC will re-assess in accordance with routine commercial re-assessment

• NYHA classification
• Left ventricle ejection fraction (LVEF)
• Whether the driver has had an episode of impaired level of consciousness

Non-commercial drivers eligible for a licence if:

• It has been 6 weeks or more since their discharge following treatment
• They have no thromboembolic complications, and
• For drivers with mechanical prostheses, mitral bioprostheses with non-sinus rhythm or mitral valve repair with non-sinus rhythm, they are on anti-coagulant therapy

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or
• An assessment from a cardiologist

• Type of surgical treatment
• Date of their discharge following treatment
• Whether there are thromboembolic complications
• Where applicable, whether the driver is on anti-coagulant therapy

Commercial drivers eligible for a licence if:

• It has been 3 months or more since their discharge following treatment
• They have no thromboembolic complications
• They are assessed as NYHA Class I
• They have an LVEF of equal or greater than 35%, and
• For drivers with mechanical prostheses, mitral bioprostheses with non-sinus rhythm or mitral valve repair with non-sinus rhythm, they are on anti-coagulant therapy

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or
• An assessment from a cardiologist

• Type of surgical treatment
• Date of their discharge following treatment
• Whether there are thromboembolic complications
• NYHA classification
• Left ventricle ejection fraction (LVEF)
• Where applicable, whether the driver is on anti-coagulant therapy

All drivers eligible for a licence if:

• They are asymptomatic, or
• Where they are symptomatic they have been assessed for arrhythmia and they meet any applicable standard for arrhythmia

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report;
• Additional information from the treating physician; or
• Assessment from a cardiologist

Non-commercial drivers eligible for a licence if:

• They are assessed as NYHA Class I, II, or III
• They are not receiving intermittent inotropes

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or
• An assessment from a cardiologist

RoadSafetyBC may find individuals fit to drive if:

• They meet above standards, or
• If the treating physician indicates possible impairment of one or more of the functions necessary for driving, RoadSafetyBC will request functional assessment(s) as appropriate for the type(s) of impairment and class of licence held, unless there has been no significant change in the individual’s condition or functional ability since a previous functional assessment

RoadSafetyBC will re-assess every 5 years or in accordance with routine age-related re-assessment, unless more frequent re-assessment is recommended by the treating physician

• NYHA Classification
• Whether the driver is receiving intermittent inotropes or using a left ventricle assist device
• Results of cognitive screening

Commercial drivers eligible for a licence if:

• They are assessed as NYHA Class I or II
• They have an LVEF of equal or greater than 35%
• They are not receiving intermittent inotropes

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or
• An assessment from a cardiologist.

RoadSafetyBC may find individuals fit to drive if:

• They meet above standards, and
• They are not using a left ventricle assist device
• If the treating physician indicates possible impairment of one or more of the functions necessary for driving, RoadSafetyBC will request functional assessment(s) as appropriate for the type(s) of impairment and class of licence held, unless there has been no significant change in the individual’s condition or functional ability since a previous functional assessment

• NYHA Classification
• LVEF
• Whether the driver is receiving intermittent inotropes or using a left ventricle assist device

Non-commercial drivers eligible for a licence if:

• They are assessed as NYHA Class I, II, or III
• They are not receiving intermittent inotropes, and
• If has left ventricular assist device (LVAD) and cardiologist report indicates is stable for 2 months post implantation

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or
• An assessment from a cardiologist

If has left ventricular assist device (LVAD), RoadSafetyBC may find individuals fit to drive if:

• They meet standard above; and
• They have a continuous flow LVAD implanted
• If the treating physician indicates possible impairment of one or more of the functions necessary for driving, RoadSafetyBC will request functional assessment(s) as appropriate for the type(s) of impairment and class of licence held, unless there has been no significant change in the individual’s condition or functional ability since a previous functional assessment

• NYHA Classification
• Whether the driver is receiving intermittent inotropes or using an LVAD
• Date and Type of LVAD implant

Commercial drivers eligible for a licence if:

• They are assessed as NYHA Class I or II
• They have an LVEF of equal or greater than 35%
• They are not receiving intermittent inotropes, and
• They are not using a left ventricle assist device

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or
• An assessment from a cardiologist

• NYHA Classification
• Left ventricle ejection fraction (LVEF)
• Whether the driver is receiving intermittent inotropes or using a left ventricle assist device

Non-commercial drivers eligible for a licence if:

• It has been 6 weeks or more since their discharge following transplant
• They are assessed as NYHA Class I or II
• They are on stable immunotherapy, and
• They meet the conditions for maintaining a licence

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or
• An assessment from a cardiologist

• Date of the driver’s discharge following transplant
• NYHA Classification
• Whether the driver is on stable immunotherapy

Commercial drivers eligible for a licence if:

• It has been 6 months or more since their discharge following transplant
• They are assessed as NYHA Class I
• They have an LVEF of equal or greater than 35%
• They are on stable immunotherapy
• They have no active ischemia, and
• They meet the conditions for maintaining a licence

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or
• An assessment from a cardiologist

Have an annual medical follow-up, including a non-invasive test of ischemic burden

RoadSafetyBC will re-assess in accordance with routine commercial re-assessment, unless more frequent re-assessment is recommended by the treating physician

• Date of the driver’s discharge following the transplant
• NYHA Classification
• Left ventricle ejection fraction (LVEF)
• Whether the driver is on stable immunotherapy
• Whether the driver has active ischemia

Non-commercial drivers eligible for a licence if:

• They have had no episodes of impaired level of consciousness

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or
• An assessment from a cardiologist

RoadSafetyBC will re-assess annually until the condition is controlled and stable and then every five years, unless routine age-related re-assessment applies

Commercial drivers eligible for a licence if:

• They have had no episodes of impaired level of consciousness
• They have no family history of sudden death at a young age
• They have left ventricle wall thickness of < 30 mm
• They show no decrease in blood pressure with exercise,
• They have no non-sustained VT, and
• They meet the conditions for maintaining a licence

If further information regarding an individual’s medical condition is required, RoadSafetyBC may request:

• A Driver’s Medical Examination Report
• Additional information from the treating physician, or
• An assessment from a cardiologist

• Whether the driver has had an episode of impaired level of consciousness
• Whether the driver has a family history of sudden death at a young age
• Whether the driver’s left ventricle wall thickness is < 30 mm
• Whether the driver shows a decrease in blood pressure with exercise
• Whether the driver has any nonsustained VT on a Holter

Non-ST elevation MI with minor LV damage

If PCI performed during initial hospital stay

If PCI not performed during initial hospital stay

Acute coronary syndrome without MI (unstable angina)

If PCI performed during initial hospital stay

If PCI not performed during initial hospital stay

Notes:

ST elevation: refers to the appearance of the ST segment of an electrocardiogram (ECG or EKG)

MI:  Myocardial infarction (heart attack) LV:  left ventricle

Significant LV damage:  any MI which is not classified as minor

Minor LV damage: an MI defined only by elevated troponin + ECG changes and in the absence of a new wall motion abnormality.

Stable angina

Notes:

Catheter ablation procedure

EPS with no inducible sustained ventricular

Notes:

Notes:

VF:  ventricular fibrillation Examples of reversible causes of VF:

• VF within 24 hours of myocardial infarction
• VF during coronary angiography
• VF with electrocution
• VF secondary to drug toxicity