Improvements in 25 Years of Implantable Cardioverter Defibrillator Therapy

In 1980, Dr. Michel Mirowski and his team inserted the first implantable cardioverter defibrillator (ICD) in a patient. Initially, ICD therapy was not widely accepted, and many physicians actually considered this therapy unethical. Large secondary and primary prevention trials, demonstrating a beneficial effect of ICD therapy in selected patients not only on arrhythmic death but also on all-cause mortality, stimulated a rapid growth in the number of implants and increased patient’s and physician’s acceptance. Improvements in size and weight, arrhythmia discrimination capabilities, battery technology, shock waveform and output, monitoring capabilities and defibrillator electrode technology eventually resulted in the current large number of yearly implants. Today, almost 40 years after the conception of the ICD and 25 years after the first human implant, ICD therapy is the treatment of choice for patients at risk for life-threatening arrhythmias either as secondary or primary prevention. Furthermore, with the more recent addition of resynchronisation therapy to standard ICD therapy, it became possible to treat selected patients with advanced symptoms of heart failure and to lower the risk of sudden death

IK1 modulates the U-wave: insights in a 100-year-old enigma.

n 1906, 11 years after Einthoven's first description of the P-QRS-T complex in a human electrocardiogram in 1895,1 he reported the existence of a wave after the T-wave, accordingly named U-wave, in a patient with “degenerative myocardial disease.” In the following years, Einthoven and Lewis noted the existence of a U-wave in the majority of their tracings. Recently, the unresolved problem of the U-wave genesis attracted renewed attention. These contradictory results prompted us to further investigate this phenomenon