Subcutaneous implantable cardioverter-defibrillator implantation in a patient with an axillary bifemoral bypass and past sternectomy

Subcutaneous implantable cardioverter-defibrillators (S-ICDs) are clinically superior to conventional transvenous ICDs (TV-ICDs) in terms of reducing lead-related complications.1,2 Moreover, S-ICDs are an effective alternative to TV-ICDs in patients with difficulty in obtaining venous access and a high risk of infection. Here we present a case of a secondary prophylactic S-ICD implantation that was passed under an axillary femoral (A-F) bypass vessel and a successful subcutaneous lead placement in a patient after a sternectomy.