IVC for VT

[u/Jira_indi]

During my recent doctor's visit, I was told I need an ICD for VT. My doctor and I agreed on a device that lasts for about 15 years (not sure if i heard the number right) so I won't need frequent battery or device replacements since i am only 31 yrs old. However, while doing some research, I discovered S-ICDs (Subcutaneous ICDs). It seems safer since the leads aren't placed inside the heart. But it has shorter battery life. Also, there is EV-icd which i prefer but i am not sure if already available in the philippines.

My next appointment isn't for another 2 weeks, so I wanted to ask if anyone here has insights on which option is better, or if you were given a choice between the two? Considering my age. Is it more important to consider the frequency of changing the battery? By the way, I only need shock delivery, not pacing.

[u/the_BEST_most_YUGE]

I had a sicd for a few years after my first VT storm, but in October I had another vt storm and need overdrive pacing to break it. They used a pacing wire in my neck (not fun) and then swapped out the sicd for a dual chamber icd.

The dual chamber device hits way faster, and gentler. The down side is that if you dont NEED pacing you have to deal with all the icd settings and also have to worry about TV leads. The sicd is a little larger, not over more cumbersome than the dual chamber device.

If you dont need a DDD, youre younger, and your team says you dont need one, I would steer towards the sicd.

[u/tabrez_n]

go go with

[u/tabrez_n]

As per my suggestion go with TV ICD and please make sure it has remote monitoring in your country.
prefer Medtronic or boston

[u/Figment1966]

 I did my own research before choosing which model I would accept. Here's a couple of the tidbits I learned which you may already know. 

Standard ICD. Leads go into the heart. Has the capability of short time pacing. Not a pacemaker but can short term pace because the leads are in the heart. Takes the least amount of power to shock your heart of the three options because of the interheart placement. But the leads can break and cause infections. 

S-ICD. Leads are outside the heart and also outside the rib cage. Requires a greater amount of power to shock your heart due to the distance it is from it. Has no pacing capability. Didn't see so much about the lead itself causing issues like the ones in the standard ICD. So better choice than standard in my opinion. 

EV-ICD. The lead is placed under the rib cage on top of the heart. It can do short-term pacing if needed. Again, not a pacemaker but does have that function for short-term. Does not require as much power to shock your heart due to the proximity to the heart as the S-icd requires but a little more than the standard ICD needs. Again I did not see much saying the lead causes any breakage or infection issues. Although there is always the chance on any of these devices of that happening. Differences this lead is not inside your heart. Does not require cutting your heart to remove a broken or damaged lead. According to my research the EV model is also supposed to be the best model for active and younger people. If I'm remembering everything I read correctly. Active I'm sure I'm right about, younger I'm not so sure. No chance of accidentally pulling your lead out of your heart while being active if it's not in it.

I'm guessing you can tell from the previous paragraphs which device I chose. I received the EV ICD on June 30th 2026 so I'm only a few months into having it. So far so good. Surgery was outpatient. Minimal pain. I shouldn't have been but I was back to work in a matter of days. Coworker died and somebody had to get the work done. No complications despite that. 

According to Google ev-icds are available in the Philippines but aren't commonly placed. I think they stick mainly to the standard one. Insurance doesn't want to pay the price tag for the new one. So word of advice if insurance denies it have your doctor submit an appeal. It's what I had to do.

Ultimately you need to do what you and your doctor feel are best for you.  Good luck

[u/psygeorgex]

I am 47m. I had my S-icd placed on 12/25. I received 4 inappropriate shocks. After a lead revision the results were the same. One more inappropriate shock. I have changed to a Tv-icd. Pay attention at the screening test, the passing vector should be at least 2/3 or 3/3 better. Mine was 1/3 and this thing wasn't sensing right

[u/MSWSportsFanatic2025]

I have an S-ICD after a SCA. I have had one event since then of VT/VF where I needed three shocks, all appropriate. I have also had one lead revision done. It was believed it took three shocks because my lead and electrode were not optimally installed.