Institutional members access full text with Ovid®

Share this article on:

The subcutaneous implantable cardioverter-defibrillator

Grace, Andrew

Current Opinion in Cardiology: January 2014 - Volume 29 - Issue 1 - p 10–19
doi: 10.1097/HCO.0000000000000031
ARRHYTHMIAS: Edited by David Birnie

Purpose of review To consider the case of need that underpinned the development of the subcutaneous implantable cardioverter-defibrillator (SICD), the preclinical and clinical data obtained so far, its current role and likely future.

Recent findings The data from prospective clinical evaluation of the device demonstrated safety and efficacy leading to Food and Drug Administration approval. This superseded earlier reports from Europe that raised some clinical concerns, previously anticipated through the introduction of new technology. Recent estimates indicate maybe 55% of patients in routine clinical practice needing an ICD are potentially suitable for a subcutaneous device.

Summary The SICD provides a useful alternative for high-energy (ICD) therapy in those deemed at risk and who need defibrillation and in whom there are no indications for cardiac resynchronization, bradycardia support or antitachycardia pacing. There is the possibility of both higher specificity and the avoidance of myo-cellular damage with shock delivery, and if these two aspects play out subcutaneous defibrillation could become an option of choice in many settings.

Papworth Hospital, Cambridge, UK

Correspondence to Andrew Grace, University of Cambridge, Department of Biochemistry, Tennis Court Road, Cambridge CB2 1QW, UK. Tel: +44 1480 364350 (clinical secretaries); e-mail:

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins