New technologies of internal defibrillation.

This paper reviews recent research seeking to provide more efficient device oriented treatments for atrial and ventricular fibrillation to improve implantable cardioverter defibrillator (ICD) therapy. Investigators have proposed and tested many innovative technologies that may be included in future ICDs. Amongst the most promising technologies are combined cardiac resynchronization therapy and defibrillation, defibrillation coils in the coronary venous system, critical timing of defibrillation shocks, and pacing during ventricular fibrillation and tachycardia. Atrial defibrillation with ICDs is an area of considerable interest, but is not likely to gain widespread application unless acceptable methods of lowering pain associated with defibrillation shocks are implemented.