Prevention of sudden death for patients with cardiomyopathies: Another step forward

摘要

It has now been >30 years since the implantable cardioverter-defibrillator (ICD) was introduced to the cardiovascular community for the prevention of sudden cardiac death (1). Perhaps it is no longer common knowledge that the defibrillator was conceived and initially developed >40 years ago by Drs. Michel Mirowski and Morton Mower, not in an eminent medical institution with the robust support of industry and the National Institutes of Health, but rather in the basement of a small, private hospital (Sinai Hospital, Baltimore, Maryland), initially with no formal funding. This entirely novel concept was initially met with substantial skepticism and even antagonism (2), but eventually moved forward, driven by the vision of Mirowski and Mower, until it became the acknowledged treatment to prevent sudden death due to ventricular tachyarrhythmias, largely for high-risk patients with coronary artery disease (CAD) and myocardial infarction. Certainly, it was not unexpected that this large group of patients would become the impetus for developing the ICD, as well as the core recipients of this technology, as it evolved over the decades with numerous randomized trials documenting its efficacy and superiority over pharmacologic strategies .