The implantable cardioverter de fibrillator: Technical and clinical considerations

Abstract

The implantable cardioverter de fibrillator (ICD) has become the most common device implanted for the treatment of arrhythmia disorders. The enormous technological development of these devices is perhaps the most dramatic progression observed in medicine over the last 30 years. The initial experiments of Mirowski published in 1978 required an external unit developed into epicardial patches and a large abdominal human implantable device released in 1985 and this yielded to transvenous leads in the early 1990s and smaller pectoral and dual chamber devices in the late 1990s and ultimately to combine cardiac resynchronization devices with de fibrillation in the first few years of the new millennium. The aim of this chapter is to review the current ICD indications based on the results of the most recent published trials, comment about the technical aspects involved in the design, implant and testing of the devices and an overview of the follow up recommendations.