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We describe two cases of secondary prevention subcutaneous implantable cardioverter defibrillator (S-ICD) implantation and subsequent S-ICD electrode displacement which initially went undetected. One presentation was a result of a coincidental chest x-ray for respiratory exacerbation and another with an untreated episode highlighted via remote monitoring, both patients were booked to clinic for further investigation. Our findings highlighted had there been a comparison of the existing subcutaneous electrogram (S-ECG) to captured S-ECGs at time of implant the electrode displacement would have been detected beforehand. This underpins the importance of introducing the simple management strategy into routine follow-up.

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