Implantable Cardioverter Defibrillator Technology in the Next 10 Years: What Can Be Expected?

Abstract

Fifteen years after the first implantation of an automatic defibrillator in humans (1), therapy with implantable cardioverter defibrillators (ICD) might become the therapy of first choice in patients with malignant ventricular tachyarrhythmias in the near future (2).The first ICD had no cardioversion and defibrillated the patient once a rhythm was observed above a fixed nonprogrammable heart rate (1). Defibrillation occurred after a fixed duration with a fixed energy. The ICD had to be implanted by a thoracotomy, as at least one defibrillation patch had to be positioned epi-cardially. Due to its volume of 145 ml, the device had to be implanted abdominally. Since 1980, major technical developments have been made which have improved ICD therapy and facilitated its widespread use (3).