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Implanted Standby Defibrillators

W HEN A PROBLEM gains wide social consciousness a diversity of practical and impractical solutions is engendered. This is now the case with the formidable problem of sudden death in patients with coronary heart disease. Sudden death largely afflicts the ambulatory subject, prodromes are not distinctive, lead time is short, and death probably results from ventricular fibrillation (VF). Tragedy is magnified by the realization that the heart may have been only minimally impaired, that the arrhythmia could have been reversed, and, if reversed, a long and productive life would have been possible. Hospital experiences during this past decade have amply demonstrated that survival depends upon promptness in defibrillation. The time for effective action is limited to a few minutes. It seems unlikely, therefore, that medical intervention after the event will yield a substantial harvest