ABSTRACT
Survivals of sudden cardiac death [SCD] episodes have recurrence rate of 30-50% within two years, with malignant ventricular arrhythmias most often responsible. The overall survival rate for SCD in USA is 5%. Ninety-five percent of patients suffering their initial event fail to survive to become candidate for secondary prevention. Because of the wide spread acceptance of implantable cardioverter defibrillator [ICD] as a method treating the survivals of SCD, attention has turned to primary prevention. Implantable cardioverter-defibrillator [ICD] is highly effective in primary and secondary prevention of SCD due to life threatening ventricular tachycardia [VT]. To register and interpret the results of implantation and follow-up of ICD during the period between 2002-2007 in Ibn Al-Bitar hospital. Sixty patients with standard indications for ICD; data were pooled from patients history, ECG, Echocardiography, Holter, blood investigation and coronary angiography.75% males and 25% females. After implantation, class III anti-arrhythmic drugs [Amiodarone] were stopped, except for patients with a history of supraventricular tachycardia or recurrent VT. Coronary artery disease [CAD] was the most common presentation of patients for whom implantation was done; coronary artery disease [CAD] 43%, dilated cardiomyopathy [DCM] 26%, and hypertrophic obstructive cardiomyopathy [HOCM] 16%. Sixty-three of them had moderate-severe LV dysfunction [LVEF<40%]. Recurrent VT was the most common cause of implantation [76%]. Primary prevention was aimed in [60%] of patients and secondary prevention in 40%. Sixty percent of those with ICD implanted due to primary prevention fulfil MADIT II [Multicenter Automatic Defibrillator Implantation Trial II] criteria. The majority of patients had structural heart disease. Most non-sustained VTs reverted to sinus rhythm by antitachycardia pacing [ATP] therapy from ICD [90%].A11 VF events reverted to sinus rhythm by high energy shock from ICD devices. ICD is highly effective in primary and secondary prevention of life threatening VT/VF