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How implantable cardioverter-defibrillators work and simple programming

  • Randall M. Bryant (a1)


Following the sudden death of a friend in 1966, Dr Michel Mirowski began pioneering work on the first implantable cardioverter-defibrillator. By 1969 he had developed an experimental model and performed the first transvenous defibrillation. In 1970 he reported on the use of a “standby automatic defibrillator” that was tested successfully in dogs. He postulated that such a device “when adapted for clinical use, might be implanted temporarily or permanently in selected patients particularly prone to develop ventricular fibrillation and thus provide them with some degree of protection from sudden coronary death”. In 1980 he reported on the first human implants of an “electronic device designed to monitor cardiac electrical activity, to recognise ventricular fibrillation and ventricular tachyarrhythmias … and then to deliver corrective defibrillatory discharges”. Through innovations in circuitry, battery, and capacitor technologies, the current implantable cardioverter-defibrillator is 10 times smaller and exponentially more sophisticated than that first iteration. This article will review the inner workings of the implantable cardioverter-defibrillator and outline several features that make it the wonder in technology that it has become.


Corresponding author

Correspondence to: R. Bryant, MD, Interventional Electrophysiology and Pacing, Associate Professor of Pediatrics (Cardiology), University of Florida – Jacksonville/Gainesville, 841 Prudential Dr; Suite #100; Jacksonville, FL 32207, United States of America. Tel: +904 493 1610; Fax: +904 633 4111; E-mail:


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1. Wood, MA, Swerdlow, C, Olson, WH. Sensing and arrhythmia detection by implantable devices. In: Ellenbogen KA, Kay GA, Wilkoff BL (eds). Clinical Cardiac Pacing and Defibrillation, 2nd edn. WB Saunders Company, Philadelphia, Pennsylvania, 2000: 68126.
2. Gilliam, FR, Hayes, DL, Boehner, JP, et al. Real world evaluation of dual-zone ICD and CRT-D programming compared to single-zone programming: the ALTITUDE REDUCES study. J Cardiovasc Electrophysiol 2011; 22: 10231029.
3. Mahaven, M, Friedman, P. Optimal programming of ICDs. Circulation 2013; 128: 659672.
4. Lee, MA, Corbisiero, R, Nabert, DR, et al. Clinical results of an advanced SVT detection enhancement algorithm. PACE 2005; 28: 10321040.
5. Freidman, PA, Swerdlow, CD, Asirvatham, SJ, Hayes, DL. Programming: maximizing benefit and minimizing morbidity programming. In: Hayes DL, Asirvatham SJ, Friedman PA (eds). Cardiac Pacing, Defibrillation and Resynchronization: A Clinical Approach, 3rd edn. Wiley-Blackwell, Hoboken, New Jersy, 2013.
6. Gulizia, MM, Piraino, L, Scherillo, M, et al. A randomized study to compare ramp versus burst antitachycardia pacing therapies to treat fast ventricular tachyarrhythmias in patients with implantable cardioverter defibrillators: the PITAGORA ICD trial. Circ Arrhythm Electrophysiol 2009; 2: 146153.
7. Wilkoff, BL, Williamson, BD, Stern, RS, et al. Strategic programming of detection and therapy parameters in implantable cardioverter-defibrillators reduces shocks in primary prevention patients: results for PREPARE (Primary Prevention Parameters Evaluation) study. J Am Coll Cardiol 2008; 52: 541550.
8. Russo, AM, Chung, MK. Defibrillation testing is necessary at the time of implantable cardioverter defibrillation. Circ Arrhythm Electrophysiol 2014; 7: 337346.


How implantable cardioverter-defibrillators work and simple programming

  • Randall M. Bryant (a1)


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