SICD is an alternative to conventional ICD’s which are transvenous for sudden cardiac death protection. This device has been clinically available since 2012. The advantage of SICD is lack of vascular complication, and lead related issues. Also, since it is subcutaneous, infection can be treated easier and it does not lead to endocarditis ( infection involving cardiac valves). In addition, if lead or device ever needs to be removed, it is done easier than with transvenous devices which after a year may require last guidance. However, since it does not provide pacing, it is not indicated for anyone who requires either pacing or cardiac synchronization therapy. The latter group of patients would benefit from transvenous devices. Also, with SICD’s there is no restriction for 6 weeks with arm movement. The battery longevity is about 5 years. Ideal patients for these devices are ones with vascular access issues such as dialysis patients, patients with high risk for infection and young and relatively active patients who need a device for sudden death protection ( such as patient’s with Brugada syndrome). I have inserted SICD’s in both men and women with great results. Prior to being considered for SICD, the patient needs to undergo simple EKG screening. Dr. Angella has been inserting the SICD’s since they became available in 2012.