Implantable Defibrillators: Which Is the Best Device for Each Patient?

The first viable alternative to surgical implantation of an epicardial defibrillator system for secondary prevention of sudden cardiac death (SCD) was a single chamber transvenous implantable cardioverter defibrillator (ICD). Thanks to technological advancements over the past 40 years, electrophysiologists now have several options when determining the optimal type of ICD to provide protection against SCD, including the number of leads implanted, whether a patient meets indications for cardiac resynchronization, and if the patient would benefit from an extravascular device. In this review, we will detail the breadth of options for commercially available ICD therapy to provide guidance on which device is best suited for specific patient populations.