IMPLANTABLE DEFIBRILLATORS IN THE MANAGEMENT OF MALIGNANT VENTRICULARTACHYARRHYTHMIAS

Background: Implantable defibrillators are the most effective means to prevent sudden death in patients with malignant ventricular tachyarrh ythmias. The availability of this type of devices is limited in Chile, due to their high price. Aim: To report the first patients treated wi th implantable defibrillators in our hospital. Patients and methods: N ine males and one female aged 13 to 65 years old are reported. Three p resented with ventricular fibrillation (presenting out of the hospital in three) and the rest had ventricular tachycardia resistant to drugs or radiofrequency ablation. Results: All implants were performed usin g intracardiac electrodes. The generator was implanted in the pectoral region in nine and in the abdomen in one. A successful defibrillation was obtained with less than 15 J in four patients, with 20 J in three and with 24 J in three. There were no complications during the proced ure. After a 12 months follow up, four patients have been treated by t he implantable device. One of these subjects had a ventricular fibrill ation in two occasions. One patient died of a bronchopneumonia two yea rs after the implant. Conclusions: Implantable defibrillators are an e ffective therapy for the treatment of malignant ventricular arrhythmia s with a high risk of sudden death.