William Payne told traffic police investigating the tragedy in North Hanover Street, Glasgow, "I thought I was fit to drive."
Mr Payne then went on to tell officers he had been suffering blackouts since Christmas Day 2007 and he claimed doctors told him it was a viral infection. In an interview Mr Payne said his doctors had never told him there was a possibility of collapsing at the wheel.
Mhairi Convy, 18, of Lennoxtown, and Laura Stewart, 20, of Cumbernauld, who were students at Glasgow College Of Commerce, were killed on December 17, 2010, after Mr Payne's Range Rover hit them.
Mr Payne said the last thing he remembered was sitting at the traffic lights and then someone talking to him in his car after the accident.
The inquiry at Glasgow Sheriff Court heard Mr Payne held an HGV licence as well as an ordinary licence. He was asked about why he had not said that he had suffered any blackouts before. He said: "They kept telling me it was a viral infection."
Mr Payne revealed a pacemaker had been fitted.
Mr Payne, now 53, was asked why he had not informed DVLA or his insurance company about the blackouts and told police his doctors told him it was a viral infection and gave him antibiotics to clear it up.
The court heard that for two and half years Mr Payne complained about feeling unwell, with persistent sore throats and feeling tired. He said he had had eight or nine blackouts but there was no warning of them.
After the tragedy he surrendered his licence.
The inquiry continues.