Opportunities and drawbacks of the subcutaneous defibrillator across different clinical settings

Abstract

Introduction: The subcutaneous implantable cardioverter-defibrillator (S-ICD) is an established therapy for the prevention of sudden cardiac death (SCD) and an alternative to a transvenous implantable cardioverter-defibrillator system in selected patients. Beyond randomized clinical trials, many observational studies have described the clinical performance of S-ICD across different subgroups of patients.

Areas covered: Our review aimed to describe the opportunities and drawbacks of the S-ICD, focusing on their use in special populations and across different clinical settings.

Expert opinion: The choice to implant S-ICD should be based on the patient's tailored approach, which takes into account the adequate S-ICD screening at rest or during stress, the infective risk, the ventricular arrhythmia susceptibility, the progressive nature of the underlying disease, the work or sports activity, and the risk of lead-related complications.

Keywords: Subcutaneous implantable cardioverter-defibrillator; cardiomyopathy; inappropriate shock; lead-related complications; psychosocial issues; sports activity; sudden cardiac death; work activity.