Can patients with neuromediated syncope safely drive motor vehicles?

This study is a retrospective analysis of patients in a community-based university clinic, and only patients with a positive isoproterenol tilt-table test result were included. There are numerous tilt-test protocols in use in various centers, and their comparative sensitivities, specificities, and cross-validities are unknown. Indeed, our protocol may be less specific than prolonged drug-free head-up tilt in younger patients. Thus, the estimates in this study may not be generalizable. Finally, the estimates were based on patients recollections of accidents, and it is possible that the number of accidents is underreported. Nonetheless, the risk of syncope causing harm appears to be so low that most patients may be allowed to drive.