Since the first implant in 1980, and Food and Drug Administration (
FDA) approval in 1985, implantable cardioverter-defibrillators (ICDs) have become the mainstay for treatment of ventricular arrhythmias and the prevention of sudden cardiac death (
SCD).
1 ICD implantation is increasing exponentially worldwide. During the last world survey in 2009, it was estimated that there were 328,027 ICDs implanted, with 222,407 new implants and 105,620 replacements.
2 In the 40 years since their introduction, ICDs have become much smaller, longer-lasting, and multifeatured. As a result, the implantation of a dual-chamber
ICD system is very similar to the implantation of a permanent pacemaker. Beyond defibrillation, modern ICDs are able to apply antitachycardia pacing to terminate up to 83% of ventricular arrhythmias, characterize and record arrhythmias, assess activity levels and monitor heart failure parameters, and provide cardiac resynchronization therapy (
CRT).
3 As the indications for ICDs and
CRT have expanded, so too has the number of these devices implanted. In the last decade, the development of a subcutaneous
ICD (S-ICD) has provided yet another option in the prevention of
SCD.
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