[Inactivation of the intracardial cardioverter/defibrillator (ICD) antitachycardial function in dilated cardiomyopathy. Driver can again work in her occupation].

HISTORY: Cardiac synchronization treatment with implanted cardiac defibrillator (CRT-ICD) had been given to a 52-year old women because she had markedly reduced left ventricular function and a left bundle branch block. She had already improved to NYHA class II two weeks after the initial diagnosis and treatment of a non-ischemic dilated cardiomyopathy at another hospital. A lorry drinving license was denied to her, a professional lorry driver.

TREATMENT AND COURSE: By the time that the patient asked for a second opinion at our hospital six months later, left ventricular function had improved as a result of CRT and cardiac medication. There was thus no longer an indication for primary preventive ICD implantation, left ventricular function no longer being present. As the rhythmogenic hazard was comparable to that without implanted device (in which case professional driving would be allowed), anti-tachycardic ICD function was inactivated so that the patient could work again as a lorry driver.

CONCLUSION

This case underlines the impact of the significance of the interval between diagnosis of a cardiac disease and primary preventive insertion of an ICD, as suggested by the guidelines, especially in patients with non-ischemic dilated cardiomyopathy.