ICD (Implantable Cardioverter Defibrillator ): this device can detect and treat Ventricular Tachycardia and Ventricular Fibrillation. Usually the first treatment is anti-tachy pacing (pacing at a rate +- 10% above the ventricular rate in ventricular tachycardia, which can convert the rhythm to sinus rhythm). If this is not effective an defibrillator shock is delivered, usually with 16-36 Joules of energy. ICDs can save lives in patients who have a high risk of ventricular arrhythmias. All ICDs have optional pacemaker activity to treat bradycardias. New biventricular ICDs have 3 leads: an atrial lead, a left ventricular lead and a right ventricular lead.
A short history of ICD therapy
- 1849 First graphical registration of VF
- 1899 First documented defibrillation of a dog with ventricular fibrillation (VF) in dogs.
- 1947 The thoracic surgeon Claude Beck saved the first human life by the successful use of cardiac defibrillation in a 14-year-old boy who developed VF during a thoracic surgical procedure and went on to achieve a full recovery.
- 1973 Concept of implantable ICD
- 1980 First human implantation of an ICD
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- Beck C, Pritchard W, Heil H. Ventricular fibrillation of long duration abolished by electric shock. JAMA. 1947; 135: 985–986.
- Mirowski M and Mower MM. Transvenous automatic defibrillator as an approach to prevention of sudden death from ventricular fibrillation. Heart Lung. 1973 Nov-Dec;2(6):867-9.
- Mirowski M, Reid PR, Mower MM, Watkins L, Gott VL, Schauble JF, Langer A, Heilman MS, Kolenik SA, Fischell RE, and Weisfeldt ML. Termination of malignant ventricular arrhythmias with an implanted automatic defibrillator in human beings. N Engl J Med. 1980 Aug 7;303(6):322-4. DOI:10.1056/NEJM198008073030607 |