AICD(TM) AUTOMATIC CARDIOVERTER-DEFIBRILLATOR CLINICAL UPDATE - 14 YEARS EXPERIENCE IN OVER 34,000 PATIENTS

The appearance of this publication, will mark, almost to the day, the date of the first AICD(TM) implantation, by Mirowski et al., on Feb. 4 , 1980.(1) Another historical milestone will also have been reached: t he total patients implanted worldwide will exceed 50,000! The data rep orted here cover the 34,000(+) implanted with CPI devices, from Dr. Mi rowski's first implant through the end of 1993. The demographic data f or these patients are summarized in Table I. They are quite comparable to the patient characteristics reported in a large number of major im plantable cardioverter defibrillator (ICD) series.(2) Freedom from sud den cardiac death (SCD) with the AICD(TM) has consistently been about 1% per year, which has been confirmed from numerous single center seri es.(3-5) From the CPI clinical data bank, the actuarial freedom from s udden death for patients with an AICD(TM) is 98.4% at 1 year, 97.6% at 2 years, 95.6% at 5 years (N = 3,629), and 89.7% at 10 years (N = 50) . The key questions we have analyzed in this study concern whether the 14-year evolution in technology and physician acceptance have modifie d: (1) patient selection; and (2) outcome (patient survival).