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Whilst ICD are more commonly implanted transvenously (TV), this approach carries high risk of peri- and post-procedural complications. Subcutaneous ICD (S-ICD) have been introduced to overcome the intravascular complications of TV system by placing all metalware outside the chest cavity for those with an indication for a defibrillator and no pacing requirements. In conclusion, a review of the current guidelines recommendations regarding S-ICD may be needed considering the emerging evidence which shows high efficacy and safety with contemporary devices and programming algorithms. A stronger recommendation may be developed for selective patients who have an indication for single-chamber ICD in the absence of negative screening, recurrent monomorphic ventricular tachycardia, cardiac resynchronization therapy, or pacemaker indication. These criteria encapsulate a large proportion (around 70%!) of all ICD eligible patients.<\/jats:p>","DOI":"10.1007\/s00392-022-01990-8","type":"journal-article","created":{"date-parts":[[2022,2,18]],"date-time":"2022-02-18T07:10:46Z","timestamp":1645168246000},"page":"475-478","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Subcutaneous ICD for more and transvenous ICD for few?!"],"prefix":"10.1007","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0847-1694","authenticated-orcid":false,"given":"Amr","family":"Abdin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suleman","family":"Aktaa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,2,18]]},"reference":[{"key":"1990_CR1","first-page":"e210","volume":"138","author":"SM Al-Khatib","year":"2018","unstructured":"Al-Khatib SM, Stevenson WG, Ackerman MJ, Bryant WJ, Callans DJ, Curtis AB et al (2018) 2017 AHA\/ACC\/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: executive summary: a report of the American College of Cardiology\/American Heart Association Task Force on clinical practice guidelines and the Heart Rhythm Society. 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