OBJECTIVETo explore the effect of implantable automatic cardioverter defibrillator (ICD) on improvement of the prognosis of patients with ventricular tachycardia or fibrillation (VT/VF). To compare the advantages and disadvantages of ICD with antiarrhythmic drug, to select the best indication of ICD and review the protocol of the following-up of ICD patients, and present scientific evidence for the morebroad popularization who needs ICD in China.

METHODSIn 99 selected patients who had the indication of class I, 27 patients were treated by ICD (ICD group), and 72 patients were not (non-ICD group). Patients in the two groups had the similar basic clinical characteristics. The incidence of syncope, CPR, and VF in ICD group were more common than those in non-ICD group. Patients in the two groups received same basic therapy. The total mortality rate and the incidence of cardiac events in two groups were compared in 3 months, 6 months, 12 months and 15 months.

RESULTSThe total mortality rate and the incidence of cardiac events in ICD group were significantly lower than those in non-ICD group in the follow-up period. The mortality rate in ICD group is 0, and the mortality rate in non-ICD group is 20.8%.

CONCLUSIONS(1) ICD treatment can decrease the incidence of cardiac events of patients with high risk of sudden cardiac death (SCD), and improve their survival. (2) The key measures to insure the efficacy, safety, and cost-effectiveness of ICD treatment is: to select the patients correctly, to optimize the implanting process and the follow-up, and use rational assistant therapy.