SUBJECTS AND METHODS: Between Aug. 1997 and Feb. 2004, 28 patients who had undergone an ICD implantation at the Yonsei Cardiovascular Center were retrospectively analyzed.

RESULTS: There were 28 patients (24 men, 4 female), with a mean age of 48±13.1 (21-74) years. ICD implantation was performed in 2 and 26 patients for the primary and secondary preventions of sudden cardiac death. Eight patients (28.6%) had neither a structural heart disease nor an electrical disease, but 8 (28.6%) had Brugada Syndrome. Twelve patients (42.8%) presented with structural heart disease. The most frequent documented clinical arrhythmia was ventricular fibrillation, which occurred in 11 patients (39.3%). During the mean follow-up of 29.3 months, the were 60 events of tachyarrhythmia triggered shock; 25 of these were from inappropriate shock due to atrial fibrillation (1 6), sinus tachycardia (6) and farfield T wave sensing (3). Two patients died: one of stomach cancer and the other died suddenly without DC shock. An autopsy revealed a moderate amount of bloody pericardial effusion, but unknown hemodynamic significance.

CONCLUSION: The implant of an ICD is an effective measure for the secondary prevention of sudden cardiac death. Dual-chamber ICD is desirable for the prevention of inappropriate ICD shock for supraventricular tachyarrhythmias.