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Technologic advances in implantable cardioverter defibrillators
C A Swygman1, M K Homoud, M S Link
1New England Medical Center, Boston, MA 02111, USA.
Current Opinion in Cardiology
|February 5, 1999
Summary
Technological advancements have made implantable cardioverter defibrillators (ICDs) smaller and more effective for preventing sudden cardiac death. Future ICDs promise even greater capabilities, including arrhythmia prediction and prevention.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Devices
Background:
- Implantable cardioverter defibrillators (ICDs) have undergone significant technological evolution.
- These advancements have led to improved device performance, including detection, therapy delivery, and data storage.
Purpose of the Study:
- To review the recent technological advances in ICDs.
- To discuss the expanded indications for ICD implantation.
- To explore future directions in ICD development.
Main Methods:
- Review of technological improvements in ICDs.
- Analysis of clinical trial data for expanded indications.
- Discussion of advancements in lead systems and energy waveforms.
Main Results:
- Current dual-chamber ICDs offer advanced features like rate-responsive pacing, enhanced detection algorithms, and extensive diagnostics.
- Nonthoracotomy leads implanted in the pectoralis area are now standard.
- Clinical trials support expanded ICD use for primary and secondary prevention of sudden cardiac death.
Conclusions:
- Continued progress in capacitor, battery, and lead technology is expected to yield smaller, lower-output ICDs.
- Future ICDs may feature expanded indications and integrated physiologic sensors for hemodynamic assessment and arrhythmia prediction.