A driver with coronary heart disease has been prescribed Flecainide. What is the resulting action regarding their certification?

A driver diagnosed with coronary heart disease and prescribed Flecainide poses a significant concern for medical certification due to the potential implications regarding their cardiac function. The key aspect in evaluating driving safety and fitness for duty is the ejection fraction, which measures the percentage of blood pumped out of the heart's ventricle with each beat.

A reduced ejection fraction, especially below 40%, suggests compromised cardiac function, which significantly increases the risk of sudden incapacitation while driving. This is a critical factor as safety regulations prioritize ensuring that commercial drivers do not pose a danger to themselves or others on the road.

In this context, the disqualification is warranted because the presence of coronary heart disease coupled with a low ejection fraction is recognized as a condition that is likely to affect the driver's ability to operate a commercial vehicle safely. Hence, certification cannot be granted under these circumstances, emphasizing the importance of cardiac health in the evaluation process for drivers with such medical histories.