Termination of Malignant Ventricular Arrhythmias with an Implanted Automatic Defibrillator in Human Beings

2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing

“…The argument for rapid detection of VT and VF derived from a number of factors. Initial skepticism regarding the feasibility of sudden death prevention with ICDs, the fact that early ICD patients had all survived one or more cardiac arrests, concern for undersensing and underdetection (of VF in particular), demonstration of an increasing defibrillation threshold with prolonged VF duration, and the increased energy requirement of monophasic defibrilla-tion all created a culture of programming for rapid tachycardia detection and the shortest possible time to initial therapy [75][76][77]. The initial generations of ICDs did not record and save electrograms (EGMs), leading to a reduced appreciation for the frequency and impact of inappropriate shocks.…”

Implantable Cardioverter-Defibrillators in Sudden Cardiac Death Prevention: What Guidelines Don't Tell

“…Each decade played a distinctive role in the evolution of ICD therapy. From the late 1960s until the first patient implant in 1980 [32], Mirowski's concept of a "standby automatic defibrillator" [33,34] met with skepticism [35] and concern about the practical difficulties in designing and manufacturing such a device [36,37]. After the first human device implant in 1980, clinical acceptance of the concept was initially slow, but began to accelerate after Food and Drug Administration approval in 1985 and Medicare coverage for limited indications in 1986.…”

Ventricular Arrhythmias in the Elderly

“…Since the first pilot study initiated at Johns Hopkins Hospital, 43) the automatic implantable cardioverter-defibrillator (ICD) has been shown to be effective in termination of life threatening ventricular arrhythmias and to improve survival rates, and most times superior to antiarrhythmic drug therapy. The rates of ICD implantation have increased at least 10-fold over the past decade with a protective effect observed across all ages within populations studied.…”