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June 2001 (Newstream) -- Medtronic, Inc. (NYSE: MDT), confirmed on June 30, 2001, that Vice President Dick Cheney received a Medtronic GEM® III DR implantable defibrillator for treating complex heart rhythm problems. The device works both as a defibrillator and rate-responsive pacemaker, and provides protection against sudden cardiac arrest (SCA), a condition that causes more than 225,000 deaths each year in the United States. Of those stricken with SCA, 95 percent die before emergency response teams are able to reach and revive them. Therefore, prompt diagnosis and treatment of heart rhythm abnormalities may be crucial to the health and well-being of the patient. The mark indicates conformance to standards of countries of the European Economic Community.

Patients such as Vice President Cheney, with a family or personal history of heart problems, should check with their physicians to determine whether they should be referred to heart rhythm specialists known as electrophysiologists for diagnosis and treatment. This is vitally important because, of the 260,000 patients each year who are newly diagnosed with heart rhythm abnormalities, only 15 percent receive the device protection recommended by American College of Cardiology guidelines.

The GEM III DR supplies therapeutic shocks for dangerously fast heartbeats, only as needed. The device also provides dual-chamber, rate-responsive pacing and synchronization for rhythms that are too slow in either the upper or lower chambers of the heart. Rate-responsive pacing senses bodily movement and adjusts its pacing rate to the patient's activity level.

The GEM III DR also incorporates enhanced PR Logic^TM, which can discriminate between fast ventricular rhythms that are life-threatening and fast atrial arrhythmias that are not. This technology combines atrial and ventricular information to analyze hearth rhythm patterns, much as a physician does when reviewing rhythm patterns on an electrocardiogram.

The pager-sized device can deliver up to 30 joules of therapeutic energy and is expected to offer five to seven years of service in typical use.

The GEM III DR device was the first in the industry to offer the capability to automatically check the effectiveness of its electrical leads without delivering painful test shocks. It also includes a Patient Alert^TM feature, which enables the device to continuously monitor its performance and alert the patient with an audible tone when it has collected data for which physician attention is required - for example, if the device has low battery voltage or its lead impedance is not within an acceptable range.

Medtronic, Inc., headquartered in Minneapolis, is the world's leading medical technology company, providing lifelong solutions for people with chronic disease. Its Internet address is www.medtronic.com.

The following image (Emergency room in the chest) and text is from Medtronic website

Today, ICDs do much more. A modern internal defibrillator such as the Medtronic GEM® III DR, is much smaller and is implanted in the upper chest. It continuously monitors the electrical conduction system of the heart, watching for dangerous patterns and delivering electrical impulses when needed that may range from a tiny pulse like a that from a cardiac pacemaker to a full, life-saving impulse that can return the heart to normal rhythm. Dangerous patterns may indicate ventricular fibrillation, ventricular tachycardia or less problematic supraventricular tachycardias that arise in the upper chambers of the heart. ICDs now also collect information for the physician to use in diagnosis and programming the device to the exact needs of the patient.

Note: Cheney is lucky: For 150,000 of the 300,000 sudden cardiac deaths each year in the U.S., sudden death is the first and only indication that the person had a heart problem.  Cheney has had 4 heart attacks.

ICD is not the only solution, and is not a low-cost solution: 
ICD save 100,000 annually - but too costly for the general population  
Four choices after defibrillation  
Earlier description of Medtronic ICD and other devices  
Defibrillation and Sudden Cardiac Attack/Death at Skyaid 
Several articles on ICD in book Fighting Sudden Cardiac Death 
Sudden Cardiac Arrest is NOT a Heart Attack  
    by the way: An ICD produces a hell of a meeting interrupter when it activates.
      "Many people say it feels like being kicked in the chest." http://www.aafp.org/afp/980115ap/980115b.html

Future ICDs may be much more gentle

26,000 ICD procedures in 1998 in the U.S. stale link Dec 2001 

St. Jude Medical has some ICD description http://www.sjm.com/4.0/4.3/4.3.3/4.3.3.shtm

How does the ICD work?  from: http://www.aafp.org/afp/980115ap/980115b.html

The ICD constantly "watches" your heart rhythm. If it "sees" that your heart is beating fast, it delivers the treatment programmed by your doctor. The types of treatment it can deliver are pacing, cardioversion and defibrillation.

• Pacing. If you have ventricular tachycardia that isn't too fast, the ICD can deliver several pacing signals in a row. When those signals stop, the heart may go back to a normal rhythm. No other treatment is needed.
• Cardioversion. If the pacing doesn't work, cardioversion can be used. In cardioversion, a mild shock is sent to the heart to stop the fast heartbeat.
• Defibrillation. If ventricular fibrillation is detected, a defibrillation shock is sent. This stronger shock can stop the fast rhythm and help the heartbeat go back to normal. The ICD can also "see" when your heart beats too slowly. It can act like a pacemaker and bring your heart rate up to normal.