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February 1971

Standby Implanted Defibrillators

Author Affiliations

Columbia, Mo

Arch Intern Med. 1971;127(2):317. doi:10.1001/archinte.1971.00310140145025

To the Editor.  —Mirowski et al and our own group have published almost simultaneously on the concept of automatic ventricular defibrillation.1, 2 While the reports of these two independent studies indicate a remarkable area of agreement concerning general design philosophy and the possible role of such systems in preventing death from ventricular fibrillation, the studies do differ in several significant aspects.Since, in a sense, these differences reflect the problem areas which must be considered as systems are developed further for possible clinical application, it is of interest to consider them at this time. First, Mirowski proposes a catheter arrangement for applying the defibrillatory pulse to the interior of the right ventricle, while we have utilized electrodes implanted between the pectoralis major muscle and the rib cage. Second, Mirowski detects fibrillation by means of a pressure transducer catheter in the right ventricle, while our system makes use of

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