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Opportunities and drawbacks of the subcutaneous defibrillator across different clinical settings.

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 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 arrhythmias susceptibility, the progressive nature of the underlying disease, the work or sports activity, the risk of lead-related complications.

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