The benefits of the Subcutaneous Implantable Cardioverter Defibrillator (S-ICD, Boston Scientific) over transvenous (TV)-ICD, including lower rates of lead-related complications and lower in-hospital complication rates in some instances, have been demonstrated in three recently published head-to-head studies by Friedman et al (JAMA Cardiol 2016;1:900–11), Honarbakhsh et al (Int J Cardiol 2017;228:280–5) and Brouwer et al (JACC 2016;68:2047–55). Additionally, a new technique (the 2-Incision technique) for S-ICD implantation and the launch of the EMBLEM S-ICD electrode (model 3501) are supporting optimisation of the technology for better patient outcomes. Jean-Benoît Le Polain de Waroux (Université Catholique de Louvain, saint Luc Hospital, Brussels, Belgium) and Jürgen Kuschyk (Medical Faculty Mannheim of the University of Heidelberg, 1st Department of Medicine, Mannheim, Germany), experienced implanters of the S-ICD, share with Cardiac Rhythm News their insights into these topics.
