[Implantable automatic defibrillators in the treatment of ventricular tachycardia]

The implantable automatic defibrillator (IAD) is the treatment of choice of malignant ventricular arrhythmias or those resistant to pharmacological or ablative techniques. However, the small number of implantations in France, the presence of many different models, the cost and sophistication of the latest models explain why IAD remain a poorly known therapeutic method because it is highly specialised and reserved for cardiological departments with a rhythmological interest. Several factors suggest that the number of implantations will increase in the future. Firstly, the techniques of implantation have been considerably simplified and associated with technological improvements of the devices, and, secondly, publication of several trials (MADIT, AVID), even if the conclusions in favour of IAD must be carefully interpreted, will change our methods of management of patients with severe ventricular arrhythmias. The current indications of IAD in ventricular tachycardia and future prospects are discussed in the light of new data.