The dawn of a new era in the struggle against sudden cardiac death

The year 2009 is important for Dutch cardiology. It marks not only the 75th anniversary of the Netherlands Society of Cardiology, but also the starting of ICD therapy, 25 years ago. The first ICD implant in the Netherlands was carried out in Utrecht by the cardiac surgeon Dr Penn with the technical assistance of Mr Seah Nisam in April 1984. The patient was referred from Maastricht by Professor Wellens. Referral was needed since Maastricht had no cardiac surgery department at that time. The patient was resuscitated from ventricular fibrillation (VF) due to coronary artery disease with left ventricular (LV) ejection fraction of 17% and appeared to be refractory to six antiarrhythmic drug regimens. Because of the very poor LV function, map-guided surgery was not an option and the patient was considered to be candidate for ICD therapy. Since at that time epicardial patch electrodes were required for shock delivery, sternotomy was needed for appropriate patch positioning. This explains why cardiac surgeons were involved in ICD implantation. …