Implantable cardioverter-defibrillator: Encyclopedia II - Implantable cardioverter-defibrillator - History of ICD

Implantable cardioverter-defibrillator - History of ICD

The development of the ICD was pioneered by Michael Mirowski’s team working at Sinai Hospital in Baltimore with the help of industrial collaborators Intec Systems of Pittsburgh. Mirowski teamed up with Mower and Staewen. Together they commenced their research in 1969 but it was 11 years before they treated their first patient. Similar developmental work was carried out by Schuder and colleagues at the University of Missouri.

More than a decade of research went into the development of an implantable defibrillator that would automatically sense the onset of ventricular fibrillation and deliver an electric countershock within 15-20 seconds, converting the rhythm to sinus rhythm. Improved versions were programmed to be able to detect ventricular tachycardia, often a forerunner of ventricular fibrillation. These were then called implantable cardioverters.

The work was commenced against much scepticism even by leading experts in the field of arrhythmias and sudden death. There was doubt that their ideas would ever become a clinical reality. In 1972 Bernard Lown stated in the journal Circulation - "The very rare patient who has frequent bouts of ventricular fibrillation is best treated in a coronary care unit and is better served by an effective antiarrhythmic program or surgical correction of inadequate coronary blood flow or ventricular malfunction. In fact, the implanted defibrillator system represents an imperfect solution in search of a plausible and practical application".

The problems to be overcome were the design of a system which would allow detection of ventricular fibrillation or ventricular tachycardia. Despite the lack of financial backing and grants they persisted and the first device was implanted in February 1980 at Johns Hopkins Hospital. Current devices now do not require a thoracotomy, and are multiprogrammable devices with pacing, cardioversion, and defibrillation abilities.

Adapted from the Wikipedia article "History of ICD", under the G.N U Free Docmentation License. Please also see http://en.wikipedia.org/wiki