Techniques for implantation of antitachyarrhythmia devices

Implantation of ATDs is similar surgically to transpericardial implantation of conventional antibradycardia pacemakers, but considerable special expertise is involved in choosing the appropriate device and deciding how it should be programmed. Experience has reinforced our view that ATD implantation should be performed in what is essentially an operating-room setting, by a qualified team possessing the necessary surgical, electrophysiologic, and technical skills. ATD follow-up is different from that of conventional pacemakers and, particularly in the case of AIDS and AICDs, requires additional specialized instrumentation and more flexibility in scheduling.