Evolution of extravascular implantable defibrillator technologies

Anna Pfenniger, Bradley P. Knight*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations


The implantable cardioverter-defibrillator (ICD) has been successfully treating patients with lethal ventricular arrhythmias for decades. The main acute and chronic complications of this therapy modality are related to the use of a transvenous lead. An entirely extravascular ICD concept was developed over the last 20 years, with emergence of the subcutaneous ICD (S-ICD). This device was approved for clinical use seven years ago, and accumulating real-life experience confirms its safety and efficacy. The main limitations related to this system include the lack of pacing capabilities for bradycardia, tachycardia or resynchronization therapy, a large size, and relatively high energy requirements for effective defibrillation. This review article summarizes current knowledge and potential future developments of the extravascular ICD technologies.

Original languageEnglish (US)
Pages (from-to)249-255
Number of pages7
JournalProgress in Cardiovascular Diseases
Issue number3
StatePublished - May 1 2019


  • Modular cardiac rhythm management system
  • S-ICD
  • Subcutaneous implantable cardioverter-defibrillator
  • Substernal lead
  • Ventricular arrhythmias

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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