Automatic implantable cardioverter defibrillator: report of the first two implants in Hawaii.

Sudden cardiac death is the major cause of death in the United States today, claiming over 400,000 victims each year, or one per minute. In the majority of cases, the underlying mechanism is malignant ventricular tachyarrhythmia, with the common substrate being abnormal myocardium from ischemic heart disease or congestive cardiomyopathy.