Use of the implantable cardioverter/defibrillator is the most significant advance in the management of patients with life botn threatening cardiac arrhythmias. This device represents an important practical as well as conceptual breakthrough in arrhythmia management. It places on firm footing use of non-pharmacologic tools for clinicians. The text, Implan table Cardioverter/Defibrillator, represents contributions by the leading clinicians in this field from both sides of the Atlantic and is a welcome addition to the library of clinical electrophysiologists as well as cardiac surgeons. The editors have well collated the critical issues related to current use of device therapy in a meaningful and practical fashion. The text amply reminds us that we are in the early growth phases of a technology that promises to completely change our approach to the cure of patients with actual or potentially life-threatening ventricular dysrhythmias. It also reminds us that Dr. Mirwoski's dream continues to live and remains as a perpetual challenge to clinicians and engineers alike to bet ter perfect and utilize device therapy for our patients. I com mend the authors and editors for a superb and timely effort. San Francisco, CA, USA Melvin M. Scheinman, M. D. Preface 1teatment of patients with ventricular tachycardia and pre vention of sudden arrhythmic death is one of the most challenging tasks of modem cardiology. 'len years ago anti arrhythmic drug therapy was the medical tool used most fre quently in the management of patients with life-threatening ventricular tachyarrhythmias.

I: Historical Evolution of the Automatic Implantable Cardioverter Defibrillator

Historical Evolution of the Automatic Implantable Cardioverter Defibrillator in the Treatment of Malignant Ventricular Tachyarrhythmias
II: Identification of the Patient at High Risk for Sudden Cardiac Death
The Role of Ambulatory ECG Monitoring in the Prediction of Sudden Cardiac Death
Identification of the Patient at High Risk for Sudden Cardiac Death: The Value of Ventricular Late Potentials
Identification of the Patient at High Risk for Sudden Cardiac Death: The Value of Electrophysiological Studies
III: Technical and Electrophysiological Aspects of the Automatic Implantable Cardioverter Defibrillator
Implantable Device Algorithms for Detection and Discrimination of Tachyarrhythmia
Does Defibrillation Obey the Fundamental Law of Electrostimulation?
Optimal Waveform Morphology for Defibrillation
Prerequisites for the Safety and Efficacy of the Implantable Cardioverter Defibrillator
The Role of Leads and Electrodes
IV: The Role of the Automatic Implantable Cardioverter Defibrillator in the Treatment of Ventricular Tachyarrhythmia
Long-Term Clinical Results with the Implantable Defibrillator
Clinical Results with the Implanted Cardioverter Defibrillator
Combining Drugs with the Implantable Cardioverter Defibrillator: Clinical Implications
Antitachycardia Pacing, Cardioversion, and Defibrillation: From the Past to the Future
Treatment Algorithm for Patients with Life-Threatening Ventricular Tachyarrhytmia
V: Surgical Aspects of Defibrillation Treatment
Defibrillator Leads: Optimizing of Configuration, Placement, and Energy Delivery
Surgical Techniques of Defibrillator Implantation
Complications Associated with the Automatic Implantable Cardioverter Defibrillator
Safety Margin for Defibrillation
VI: Living with the Implantable Defibrillator
Management and Follow-up of the Implantable Defibrillator Patient
The Social and Economic Impact of the New Implantable Cardioverter Defibrillator Technology
Outlook.