Implantation of a subcutaneous implantable cardioverter-defibrillator in a patient with epicardial defibrillation patches

The subcutaneous implantable cardioverter-defibrillator (S-ICD) was developed to provide an alternative to the transvenous implantable cardioverter-defibrillator (TV-ICD), because it is implanted without any transvenous or epicardial leads. Studies demonstrating the safety and effectiveness of the S-ICD have been published, indicating that it is a good alternative for a variety of patients eligible for a TV-ICD system.1 However, the implantation of an S-ICD in patients with epicardial defibrillation patches is not well documented and remains unclear. Herein, we describe the implantation of S-ICD in a patient with epicardial defibrillation patches and a conductor breakage in the ICD shock circuit.