Automated Implantable Cardioverter Defibrillator (AICD) Implantation For Ventricular Tachycardia

Implantable cardioverter defibrillator (ICD or AICD) is an implantable device that has the lead (wire) is inserted inside the left ventricle, and then monitors the heart's rhythm.

It is implanted in the same way as the single chamber pacemaker. the generator is located within the chest's upper part and venous access occurs through Subclavian vein. Therapies are administered via anti-tachycardia pacemakers (ATP) and shocks that change to sinus rhythm after prolonged ventricular tachycardia, or ventricular fibrillation, both which are life-threatening conditions.

In order to prevent sudden heart death ICDs can be used:

Patients with a previous myocardial infarction as well as the left ventricular ejection percentage that is less than 30 percent (MI must have occurred at minimum 40 days prior to the event to allow to recover LV Systolic function).

Patients suffering from systolic heart failure (New York Heart Association, functional classes II or III) and an ejection percentage less than 35 percent. The best medical treatment is required and at least three months have passed in the event that the systolic function returns to an ejection percentage greater than 35% for patients with non-ischemic cardiomyopathy as well as those with ischemic cardiomyopathy who underwent bypass surgery.

In order to prevent sudden heart death ICDs should be considered:

Patients with a documented cardiac arrest due to sustained ventricular tachycardia or fibrillation that is hemodynamically stable or documented sustained ventricular tachycardia despite the fact that your left-ventricular ejection ratio is greater than 35% in the event that there is no identifiable cause. All of the above should not occur within the first 48 hours following an acute coronary syndrome.

ICDs may also be indicated in the case of hypertrophic obstructive cardiac myopathy (HOCM) in the event that one or more of the following criteria are met:


  • The thickness of the interventricular septal is 30 mm or more
  • A documented ventricular tachycardia or cardiac arrest
  • The family's history is a risk factor for sudden heart death.
  • Systolic function of the left ventricle the development of wall thinned (a.k.a. "burnt out" left ventricle)