AICD(TM) AUTOMATIC CARDIOVERTER-DEFIBRILLATOR CLINICAL UPDATE - 14 YEARS EXPERIENCE IN OVER 34,000 PATIENTS

The appearance of this publication, will mark, almost to the day, the date of the first AICD(TM) implantation, by Mirowski et al., on Feb. 4, 1980.(1) Another historical milestone will also have been reached: the total patients implanted worldwide will exceed 50,000! The data reported here cover the 34,000(+) implanted with CPI devices, from Dr. Mirowski's first implant through the end of 1993. The demographic data for these patients are summarized in Table I. They are quite comparable to the patient characteristics reported in a large number of major implantable cardioverter defibrillator (ICD) series.(2) Freedom from sudden cardiac death (SCD) with the AICD(TM) has consistently been about 1% per year, which has been confirmed from numerous single center series.(3-5) From the CPI clinical data bank, the actuarial freedom from sudden death for patients with an AICD(TM) is 98.4% at 1 year, 97.6% at 2 years, 95.6% at 5 years (N = 3,629), and 89.7% at 10 years (N = 50). The key questions we have analyzed in this study concern whether the 14-year evolution in technology and physician acceptance have modified: (1) patient selection; and (2) outcome (patient survival).