Sports and Driving with an Implantable Cardioverter-Defibrillator.

Many patients with implantable cardioverter-defibrillators (ICD) want to participate in sports and many need or wish to operate a personal motor vehicle. Healthcare providers need to advise patients regarding restrictions related to these activities in the context of the clinical indication for the ICD. Ethical considerations need to be considered when advising ICD patients of restrictions to reduce risk of injury to themselves and to others when participating in either sports or driving. Shared decision-making is necessary to have ICD patients understand and comply with recommended restrictions. Guidelines have been developed based on available studies; however, studies assessing the need for ICD patients to restrict these activities are observational and often out of date. More recent studies challenge driving and sports restrictions that are recommended by the guidelines. Recommendations to ICD patients must be individualized yet be compliant with the guidelines, and need to adapt to changes in a patients' condition.