The utilization of the implantable defibrillator--a European enigma.

In the 20 years since Michel Mirowski and coworkers implanted an ICD into their first patient, the implantable cardioverter defibrillator (ICD) has become recognized as the therapy of first choice for managing patients at high risk of sudden cardiac death from ventricular tachyarrhythmias. Multiple clinical series and recently completed prospective, randomized trials have shown that ICDs are irrefutably superior to antiarrhythmic drugs in reducing