Implantable cardioverter-defibrillator (ICD) usage has increased dramatically over the past decade. In part this is due to improved patient survival after myocardial infarction, but principally this is due to the increased number of implants for primary prevention. While the salutary effects of ICD therapy in this population of patients are generally accepted, complications from ICD implantation have become a common and pressing issue. First among these complications, both in terms of frequency and impact on quality of life, is inappropriate ICD therapy.