Implantable cardioverter defibrillators (ICDs) are widely used in patients at risk for sudden cardiac death (SCD) because these devices have been highly successful in terminating life-threatening ventricular arrhythmias and in increasing survival.1

DEVICES — Current pulse generators are implanted subcutaneously in the pectoral area with single or dual pacing/defibrillator leads placed transvenously in the atria and ventricles.They are capable not only of defibrillating (>95% success rate) but also of dual chamber physiologic pacing, remote monitoring and discriminating (not always correctly) supraventricular from ventricular arrhythmias. The usual hospital bill for implanting a typical dual chamber device is about $75,000, and most must be replaced because of battery depletion after 5-7 years.

INDICATIONS — The goal of ICD therapy is to prevent premature arrhythmic death ... more      

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