Abstract
Being an entirely subcutaneous system the S-ICD avoids important periprocedural and long-term complications associated with transvenous implantable cardioverter-defibrillator (TV-ICD) systems such as lead fracture with recurrent lead revisions and systemic device infections. Further, in patients with challenging anatomic conditions or after infection the S-ICD might be reasonable. In multicenter studies and registries efficacy and safety of the S-ICD was equal or better compared to transvenous implantable defibrillators. The S-ICD® predominately might be suitable in all patients with ICD indication except patients with pacing or CRT indication, VT < 170 bpm, negative screening or in the occasional patient whose arrhythmia might be suppressed by overdrive pacing. Initially observed complications such as inappropriate shocks due to T-wave-oversensing or infections were reduced by standardized implantation techniques, operator learning curves and modification of algorithms.
