Division 9.2 For the following cardiovascular conditions, driving licences shall not be issued or renewed for applicants or drivers in the indicated groups:F1

1. (a)

   implant of a defibrillator (applies to group 2 only);

2. (b)

   peripheral vascular disease — thoracic and abdominal aortic aneurysm when maximum aortic diameter is such that it predisposes to a significant risk of sudden rupture and hence a sudden disabling event (applies to group 1 and 2);

3. (c)

   heart failure:

   • NYHA IV (applies to group 1 only),

   • NYHA III and IV (applies to group 2 only);

4. (d)

   cardiac assist devices (applies to group 2 only);

5. (e)

   valvular heart disease with aortic regurgitation, aortic stenosis, mitral regurgitation or mitral stenosis if functional ability is estimated to be NYHA IV or if there have been syncopal episodes (applies to group 1 only);

6. (f)

   valvular heart disease in NYHA III or IV or with ejection fraction (EF) below 35 %, mitral stenosis and severe pulmonary hypertension or with severe echocardiographic aortic stenosis or aortic stenosis causing syncope; except for completely asymptomatic severe aortic stenosis if the exercise tolerance test requirements are fulfilled (applies to group 2 only);

7. (g)

   structural and electrical cardiomyopathies — hypertrophic cardiomyopathy with history of syncope or when two or more of the following conditions present: left ventricle (LV) wall thickness > 3 cm, non-sustained ventricular tachycardia, a family history of sudden death (in a first degree relative), no increase of blood pressure with exercise (applies to group 2 only);

8. (h)

   long QT syndrome with syncope, Torsade des Pointes and QTc > 500 ms (applies to group 2 only);

9. (i)

   Brugada syndrome with syncope or aborted sudden cardiac death (applies to group 1 and 2).

Driving licences may be issued or renewed in exceptional cases, provided that it is duly justified by competent medical opinion and subject to regular medical assessment ensuring that the person is still capable of driving the vehicle safely taking into account the effects of the medical condition.