[Treatment with the implantable cardioverter defibrillator (ICD)]

Interventional techniques in clinical cardiology became important in rhythmology, because it is evident that antiarrhythmic drug therapy has several limitations, and side effects. The implantable cardioverter defibrillator is a very reliable tool in the therapy of ventricular fibrillation and ventricular tachycardia. Conversion of these arrhythmias is associated with the prevention of subsequent sudden cardiac death in patients who received implantation after cardiac arrest, not associated with myocardial infarction or metabolic disturbances. The exact place of the defibrillator in the treatment of ventricular tachycardia remains unsettled, as amiodarone, sotalol and catheter ablation are acceptable treatment modalities for some patients. Furthermore, associated antiarrhythmic drug therapy remains necessary in a large group of patients after implantation. The morbidity and mortality of the recently developed non-thoracotomy devices is low. The potential value of implantable defibrillators in the prevention of cardiac arrest in high-risk patients remains to be studied.