Background: The implantable cardioverter-defibrillator (ICD) has emerged as the primarynonpharmacologic option for many patients who are at continuing high-risk for fatal ventriculartachyarrhythmias.Aim of the work: Our aim was to follow-up the patients with implanted ICDs, to assess the efficacyof ICD therapy,its impact on survival, quality of life, and monitor for its related complications.Methodology: The present study included 75 patients (63 males and 12 females), their mean age was47.6+16.1 years. The mean LVEF was 43.12+15.8%. Out of the 75 pts studied, 10 had structurallynormal hearts. Of the remaining 65 pts; IHD (without dilatation) was present in 6, ICM in 29,idiopathic DCM in 19, RHD in 3, congenital heart disease in 2, HOCM in 3 and ARVD in 2 pts, andone pt with Brugada syndrome. All patients were followed-up for a mean period of 54.00+34.4months.Results:• Non-significant change in LVEF% before and after ICD implantation (43.12% vs 45.35%,respectively), however, pts with CRT-D showed significant improvement in LVEF (27.29%before vs39.5% after implantation, p value:0.02).• Non-significant improvement in NYHA class before and after ICD implantation. However,pts withCRT-D showed significant improvement in NYHA class (p value:0.05).• ICD-related complications comprised: (1) Peri-operative in 26.6% of pts, (2) Short-term in 33.3% ofpts, and (3) Long-term in 25.3% of pts.• The incidence of inappropriate detection was 25.3% with the commonest cause is inappropriatesettings in 17.3% of pts. AF comprised the commonest cause of inappropriate therapies (10.6%).Inappropriate cardioversion shocks occurred in 12% of pts vs. 9.3% for inappropriate ATP therapies.• 24% of the ICD recipients were non users,with remarkable higher prevalence of ischemia in thosewho received ICD therapy specially in pts with cardiomyopathy.• Highly significant reduction in frequent hospital readmissions post-implantation compared to preimplantation(41.3% vs. 96%, respectively).• Follow-up of pts showed 1st year survival of 93%, 2nd year survival of 89%, 3rd year survival of89%, and 1st year freedom of SCD of 98%. Cardiac death occlusion 20% of pts (12% by pump failureand 4% by incessant VT,and 4% combined ).In conclusion: ICDs have no impact on LVEF or NYHA class except in pts with CRT-D, howeverthere was significant reduction in hospital admission following ICD implantation & high survivalrate. Regular follow up schedules is the corner stone in management of these pts for detection ofproblems and appropriate programming.