Automatic implantable cardioverter-defibrillator: techniques of implantation and results

An initial experience with use of the automatic implantable cardioverter-defibrillator (AICD) is described. Twelve patients received the device. One death has occurred during a mean follow-up of 15 months, and it was due to causes other than arrhythmias. Appropriate device discharge terminating a malignant arrhythmia occurred in 9 patients (75%). The observed survival (92%) far exceeds that to be expected in survivors of sudden death treated by conventional means. There have been no operative deaths. Morbidity has been minimal, although three reoperations were required in 2 patients because of lead dislodgment. The AICD has been demonstrated to be effective in treating patients at risk for sudden arrhythmic death. It can be employed safely with minimum morbidity using a variety of implantation techniques.