EDITOR—We support Causer and Connolly's editorial emphasising the value of implantable cardioverter-defibrillators in patients with life threatening ventricular arrhythmias.1 A recent audit conducted in our cardiac unit highlights two additional issues: psychosocial concerns of patients and cost implications. We reviewed clinical records and psychosocial structured questionnaires of the 42 patients receiving their first implantable cardioverter-defibrillator (through pectoral routes) between January 1995 and February 1998 (table). To our knowledge, this is the first reported series of such patients in the …