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Einstein Institute for Heart and Vascular Health is one of the first hospitals in the Philadelphia region to offer patients the subcutaneous implantable cardioverter-defibrillator (S-ICD™), newly-approved by the FDA for patients at risk for sudden cardiac death (SCD). An implantable cardioverter-defibrillator (ICD) is a small battery-powered device that continuously monitors a person’s heart rhythm and treats sudden cardiac arrest by delivering a therapeutic dose of electricity to restore normal rhythm when it senses the heart is beating dangerously fast or chaotically (ventricular tachycardia or fibrillation). According to the American Heart Association, there are approximately 295,000 occurrences of out-of-hospital Sudden Cardiac Arrest (SCA) each year in the United States, a condition where the heart abruptly and unexpectedly stops beating, often caused by an abnormality in the person’s heart rhythm (arrhythmia). The vast majority of people who suffer a SCA do not survive. The S-ICD™ System is unique because it treats SCD without needing to place a wire in the heart like a standard ICD. Instead, with this new system, the lead is implanted just under the skin (subcutaneous) instead of connected directly to the heart, leaving the heart and blood vessels untouched. “This device represents a dramatic advance in the prevention of sudden death while avoiding the potential complications associated with having wires in the heart and blood vessels, such as infection or heart perforation,” says Allan Greenspan, MD, FACC, Director of Electrophysiology at the Einstein Institute for Heart and Vascular Health. “It’s wonderful to be able to offer this to patients.” The S-ICD System has two main components: the pulse generator which powers the system, monitors heart activity, and delivers a shock if needed, and the electrode, which enables the device to sense the cardiac rhythm and serves as a pathway for shock delivery when necessary. Both components are implanted just under the skin – the generator at the side of the chest, and the electrode beside the breastbone. Implantation with the S-ICD System can be done using only anatomical landmarks which removes the need for fluoroscopy (an X-ray procedure that is required for standard leads to be placed in the heart). “The S-ICD System opens the door for patients who previously couldn’t receive an ICD and can now get the protection they need against sudden cardiac death,” says Sumeet Mainigi, MD, FACC, FHRS, Associate Director of Electrophysiology at the Einstein Heart and Vascular Institute. The S-ICD System is intended to provide defibrillation therapy for the treatment of life-threatening ventricular tachyarrhythmia in patients who do not have symptoms of a slow heartbeat, incessant ventricular tachycardia, or spontaneous, frequently recurring ventricular tachycardia that is reliably terminated with anti-tachycardia pacing, i.e., rapid pacing techniques which avoid painful shocks in terminating tachyarrhythmias The S-ICD System is manufactured by Boston Scientific Corporation based in St. Paul, MN.