When Michel Mirowski initially conceived of the implantable defibrillator the aim was to protect the patient at risk of sudden arrhythmic death. In the late 1960s, when Mirowski and co-workers projected the development of an automatic implantable defibrillator, out-of hospital resuscitation was a rare event. However, the out-of-hospital resuscitation initiatives led by investigators from Seattl...

BACKGROUND The Multicenter Automatic Defibrillator Implantation Trial II (MADIT-II) showed a significant 31 reduction in the risk of death with primary implantable cardioverter-defibrillator (ICD) therapy during a median follow-up of 1.5 years. However, currently there are no data on the long-term efficacy of primary defibrillator therapy. METHODS AND RESULTS MADIT-II enrolled 1232 patients w...

The subcutaneous implantable cardioverter-defibrillator (S-ICD) is a safe alternative to transvenous ICD. We describe a submuscular S-ICD placement technique in a severely obese with an oversized chest. Submuscular configuration allows optimal system positioning and impendence values warranting a safe and effective shock transmission. This technique is safe and improves patients comfort.

CONTEXT Implantable cardioverter defibrillator (ICD) therapy is effective in primary and secondary prevention of sudden cardiac death among patients with prior myocardial infarction and depressed ejection fraction. However, conclusive evidence of survival benefit in patients with nonischemic cardiomyopathy (NICM) is still lacking. OBJECTIVE To determine whether ICD therapy reduces all-cause m...

Although the implantable cardioverter-defibrillator (ICD) is now established as safe and effective for prevention of sudden cardiac death (SCD) in children, pediatrics accounts for less than 1% of market share, inhibiting corporate financial incentive for development of a pediatricspecific device. Over the past two decades since the ICD became clinically available, progressive downsizing of dev...

The trans-venous implantable cardioverter defibrillator (TV-ICD) is effective in treating life-threatening ventricular arrhythmia and reduces mortality in high-risk patients. However, there are significant short- and long-term complications that are associated with intravascular leads. These shortcomings are mostly relevant in young patients with long life expectancy and low risk of death from ...

BACKGROUND The approach to treat device infection in patients with implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D) is a challenging procedure. Optimal treatment is complete extraction of the infected device. To protect these patients from sudden cardiac arrest while waiting for reimplantation and to avoid recurrent infection, a wearable ca...

OBJECTIVES The purpose of this study was to assess the incidence, predictors, and outcome of inappropriate shocks in implantable cardioverter-defibrillator (ICD) patients. BACKGROUND Despite the benefits of ICD therapy, inappropriate defibrillator shocks continue to be a significant drawback. The prognostic importance of inappropriate shocks outside the setting of a clinical trial remains unc...

AIMS Data from previous defibrillator studies raised concern about right ventricular pacing (RVP) promoting heart failure progression and mortality in implantable cardioverter/defibrillator (ICD) patients. The present observational study re-examined the association of RVP, survival, and ventricular tachyarrhythmias/ventricular fibrillation (VT/VF) in routine ICD patients with restrictively prog...

background: dextrocardia is a congenital anomaly, which may have coexistent coronary artery disease (cad), arrhythmias and conventional indications for device therapy. however, the implantation of transvenous leads can be technically challenging and the approach needs to be tailored to the patient's individual anatomy. case presentation: a 54-year-old male with dextrocardia situs inversus ...