Subcutaneous ICD implant complicated by an intraperitoneal lead course and device infection

Introduction The subcutaneous implantable cardioverter-defibrillator (S-ICD) is a novel device that demonstrates high efficacy for treatment of ventricular tachycardia and ventricular fibrillation and is an alternative to the transvenous ICD device. The safety and efficacy of the S-ICD has been thoroughly evaluated, and pooled data from the IDE and Effortless studies show only a 0.8% incidence of suboptimal electrode placement. We present a case of extreme lead misplacement that represents how a usually simple implant procedure can result in a serious complication in the hands of an inexperienced implanter.