The totally subcutaneous implantable defibrillator

The subcutaneous implantable cardioverter-defibrillator (S-ICD) is a new therapeutic option for patients at risk of sudden cardiac arrest. The device uses a pulse generator implanted in the lateral thoracic region and a tunneled subcutaneous electrode. Benefits of this configuration include the preservation of venous access and reduction in the risk of systemic infection, vascular injury, and lead failure. Clinical trials suggest that the device effectively senses, discriminates, and converts both spontaneous and induced ventricular tachycardia and ventricular fibrillation episodes with minimal complications. The S-ICD represents a novel implantable cardioverter-defibrillator configuration that may provide reliably effective therapy for malignant tachyarrhythmias.