[Defibrillator therapy 1997. Prerequisites--results--prospects].
BACKGROUND
The first human cardioverter defibrillator implant was performed in 1980. Since then, significant technological improvement has been performed and today, ICDs with multiple diagnostic and therapeutic features are available. We report on 541 patients who underwent ICD implantation between January 1984 and March 1997. Epicardial ICD implant was performed in 209 patients (39%) and 332 patients (61%) received transvenous ICDs.


RESULTS
Perioperative mortality was 2% (13 patients), significantly more frequent after epicardial (12/209 patients, 6%) than after transvenous implantation (1/332 patients) (p < 0.01). During a mean follow-up of 28 +/- 23 months, 104 patients died (20%), 15 of them (3%) suddenly. 8407 arrhythmic episodes were observed and terminated by antitachycardia pacing in 6655 (79%). Infections occurred in 13 patients (2%), electrode complications in 43 patients (8%) and inappropriate shocks in 84 patients (16%).


CONCLUSIONS
The ICD is an effective approach to treat patients with life-threatening ventricular tachyarrhythmias leading to a low incidence of sudden death. Today, there is a low operative risk and modern ICDs have multiple diagnostic and therapeutic features that allow individual ICD therapy.
Trappe
H J
HJ
Medizinische Klinik II, Universitätsklinik Marienhospital Herne, Ruhr-Universität Bochum.
D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D017147:Defibrillators, Implantable; D015716:Electrocardiography, Ambulatory; D004566:Electrodes; D004867:Equipment Design; D005500:Follow-Up Studies; D006801:Humans; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000209:etiology / Q000628:therapy*