The automatic implantable cardioverter-defibrillator (AICD) is a device of proven efficacy in life-threatening ventricular tachycardia and fibrillation. Initial experience with the AICD at the University of Miami consists of 21 patients with recurrent ventricular dysrhythmias for a total follow-up of 3-35 months (mean 19). There were two deaths in the series, one nonarrhythmic and one arrhythmic, at the fifth and tenth postoperative months respectively. There were five complications requiring reoperation in three patients. Pacemakers were required in four patients with the AICD and resulted in interesting observations. Our data concur with previously published reports of improved survival in selected patients.