The Electrical Management of Cardiac Rhythm Disorders, Tachycardia, Slide Presentation 08 History of ICDs
Point out that the time span from the first concept of the device (1966) to FDA approval (1985) was nearly 20 years!
This image shows the Riata lead. Point out: First ICDs used epicardial leads which required a thoracotomy at implant Transvenous defibrillation leads like Riata provide pacing, sensing, and defibrillation
Point out: Not only have devices made tremendous progress in the past 20 years, so has our appreciation and acceptance of these devices. Originally, clinicians regarded ICDs as extreme therapy suitable for only the most challenging cases. Gradually, indications for ICD therapy expanded to include many patients with a documented history of potentially life-threatening ventricular arrhythmias. Around that time, the notion that devices somehow replaced drugs gave way to the prevailing view today of combination therapy (drugs plus devices). Recent clinical trials have demonstrated that patients at high risk of SCD (but without a history of ventricular tachyarrhythmias) derive mortality benefits from prophylactic ICD implantation. This introduced the concept of the primary-prevention patient.