WORLDWIDE CLINICAL-EXPERIENCE WITH A DOWN-SIZED ACTIVE CAN IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR IN 162 CONSECUTIVE PATIENTS

Treatment with an ICD is the first-line treatment for survivors of sud den cardiac death. More recently, evidence accumulates that prophylact ic ICD therapy may be beneficial for selected subgroups of patients af ter myocardial infarction. Particularly for future studies on the valu e of prophylactic ICD therapy downsized devices are needed to allow ea sy pectoral implantation with a single lead configuration and featurin g extended memory capabilities. Accordingly, this study assesses the c linical performance of a downsized four th-generation ICD in 162 conse cutive patients. All devices could be successfully implanted pectorall y in 96% with a Single lead configuration with a low defibrillation th reshold of 10.6 +/- 5.2 J. During a 3-month follow-up, 26% of the pati ents received ICD therapy. Twenty percent had appropriate therapy for ventricular fibrillation (n = 9) and VT (n = 23), which was effective in all cases; Of the 450 episodes of VT, 426 were terminated by antita chycardia pacing. Fourteen patients (9%) had inappropriate ICD therapy mainly due to atrial fibrillation or sinus tachycardia, which could b e reliably diagnosed by the ICD stored intracardiac electrograms.