[Implantable pacemaker-cardioconverter-defibrillator].

The aim of this article is to introduce the automatic, implantable cardioverter-defibrillator (AICD) device in connection with the first two cases in Hungary. At present time, the indications of the AICD implantation in the European Community are as follows: recurrent sustained episodes of ventricular tachycardia ventricular fibrillation or aborted sudden cardiac (arrhythmic) death, when the treatment of the underlying heart disease and/or the application of antiarrhythmic drugs, antitachycardia surgery (or catheter ablation procedures) proved to be unsuccessful in the prevention of the ventricular tachyarrhythmias (guided by serial intracardiac electrophysiologic testing and exercise testing), Holter monitoring. On the one hand the implantation of an AICD is not a causative treatment, on the other hand the cost of an AICD is extremely expensive. On the 8th of January, 1992, the first AICD (PCD Medtronic 7217B) implantation was performed in the Hungarian Institute of Cardiology. At the first patient with dilatative cardiomyopathy, the cardioverter defibrillator discharged successfully at 16 times. Unfortunately, the implantation of this patient with AICD could prolong his life only with months due to the rapid progression of the underlying cardiomyopathy. The second patient with AICD implantation went home after the uneventful surgery. The implanted cardioverter defibrillator unit worked properly, spontaneous ventricular tachycardia was terminated successfully. The AICD treatment considerably decreases the risk of sudden cardiac (arrhythmic) deaths.