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[Implantable defibrillators. Clinical experience].

The clinical experience with the Automatic Implantable Cardioverter-Defibrillator (AICD) now extends to over 800 patients suffering from malignant ventricular arrhythmias, most of them survivors of sudden cardiac death. This device monitors cardiac rhythm for long periods of time, identifies ventricular fibrillation and life-threatening ventricular tachycardias, and then restores normal heart action with effective electrical discharges. The AICD practically eliminates the need for trained personnel and the time constraints associated with conventional out-of-hospital resuscitation, significantly decreasing the arrhythmic and total mortality rates of the implantees. Through August, 1985, 130 consecutive patients underwent implantation of the AICD at The Johns Hopkins Hospital in Baltimore; the one-year mortality due to arrhythmias was 1.7%. These results are similar to those reported by other centers. Thus, the growing clinical experience with the automatic implantable cardioverter-defibrillator has demonstrated a marked reduction of the mortality rate of the implantees.