Implantation of active can implantable defibrillators in the right pectoral region

Routinely the active can ICD is placed in the left side pectoral position, which theoretically gives optimal conditions for a low defibrillation threshold. Some patients, however, demand a right pectoral position, which possibly could result in a higher defibrillation threshold. A right pectoral position was used in 3 of 85 active can ICDs implanted in our institution from 1994. The DFT was 12 J in two and 18 J in one patient. Thus, right pectoral implantation is feasible and offers an alternative approach in selected patients.