A preview of implantable cardioverter defibrillator systems in the next millennium: An integrative cardiac rhythm management approach

The implantable cardioverter defibrillator (ICD), a primary therapeutic opt ion for preventing sudden cardiac death, has rapidly evolved since being in troduced clinically in 1980. Technologic advances in several key areas have enabled ICDs to provide more sophisticated rhythm management. Recent empha sis has been placed on dual-chamber ICDs possessing adaptive-rate pacing ca pabilities. Adoption of dual-chamber ICD systems has been rapid. The capabi lities of future ICD systems will be governed by an integrative strategy th at brings together sets of features specifically targeted at multifaceted r hythm disorders. The addition of atrial therapy will require more sophistic ated rhythm discrimination algorithms. (CD technology will improve on sever al fronts including leads, integrated circuits, batteries, and capacitors. Additionally, state-of-the-art pacemaker technology will continue to be inc orporated into ICDs, As these new ICD systems become increasingly sophistic ated from an engineering viewpoint, tremendous emphasis will be placed on d ecreasing the complexity of programming, device interrogation, and patient monitoring during routine patient follow-up. Vast improvements in ICD progr amming systems may ultimately permit the 1-minute follow-up. (C) 1999 by Ex cerpta Medica, Inc.