Implant Technique

Standardising the S-ICD Implant

The EMBLEM™ MRI S-ICD System ensures a simple, predictable and consistent implant procedure.  Advancements in anaesthesia and implant technique result in optimal pain management, placement, and positioning, to improve patient outcomes. 

implant procedure


As the implant technique and clinical data for S-ICD continues to advance, it is important to understand the evolving anaesthesia options for the management of patients undergoing S-ICD placement. There are multiple proven periprocedural sedation and anaesthesia options for S-ICD implants, including general anaesthesia, monitored anesthesia care, regional anaesthesia (Truncal Blocks), and non-anaesthesia administered sedation and analgesia.1

Three Incisions Subcutaneous
Two Incisions Subcutaneous
Plane Blocks
General anaesthesia is not required for the majority of patients for the experienced S-ICD implanter. The focus of the implanting physician and the anaesthesia services should be to maximize patient comfort and select the best anaesthetic that best fits the patient and your program.1
Intermuscular Pocket Formation Video

On-demand interactive webinar

Cadaver demonstration of surgical anatomy and loco-regional blocks for S-ICD implant

Explore additional periprocedural sedation and anaesthesia options for S-ICD implants on EDUCARE

Intermuscular Technique

The intermuscular technique positions the pulse generator postero-laterally between the anterior surface of the serratus anterior and the posterior surface of the latissimus dorsi and helps drive a predictable and consistent implant experience. 
The intermuscular technique has many benefits.2-7

  • Optimal position for DFT and impedance measurements 
  • Reduced risk of pocket complications (erosion and infection) 
  • Reduced device migration 
  • Consistency in implant technique 
  • Enhanced patient comfort as the device is protected by the muscle layer 
  • Excellent cosmetic outcomes 
  • Intermuscular placement can be particularly beneficial in low and high BMI patients 
Formation of the Intermuscular Pocket
Make an incision along the inframammary crease. The pocket is created by blunt dissection between the serratus anterior and the latissimus dorsi muscles (muscle fibers are not cut), with the majority of the pulse generator placed behind the latissimus dorsi. This area is generally free from blood vessels.2,3
From the incision, the subcutaneous tissue is dissected directly down to the fascia, the contour of the chest wall is followed to create the pocket. The pulse generator is secured to the fascia of the serratus anterior.2-7
Intermuscular Pocket Formation Video

Intermuscular Pocket
Formation Video

Excellent Cosmetic Outcomes and Optimal S-ICD Placement
Optimal S-ICD Placement
Optimal Front View S-ICD Placement

Optimal S-ICD Placement

Optimal S-ICD Side View Placement
Excellent Cosmetic Outcomes
Emblem MRI S-ICD Cosmetic Outcomes

Optimal S-ICD Placement

Emblem MRI S-ICD Cosmetic Outcomes
Intermuscular Pocket Formation Video

Intermuscular Implant Technique for S-ICD


S-ICD Replacements

When replacing an S-ICD device, it is critical to assess the current position of the S-ICD system and determine corrective actions. Watch the video below to better understand how to approach an S-ICD replacement while using best practices.

Best Practices on S-ICD Replacements

Best Practices
on S-ICD Replacements

Education & Training

Education & Training

Our easily accessible educational platform, EDUCARE, offers you a personalised suite to support your medical education requirements.
why sicd

Why S-ICD?

See how S-ICD helps protect patients at risk for sudden cardiac death while also eliminating the risk of TV-ICD lead complications.

Clinical Data

Clinical Data

Explore clinical outcomes and learn about the first prospective, randomized, non-inferiority clinical trial comparing S-ICD to TV-ICD


Videos & Resources

Hear physician perspectives about S-ICD, find media information, and download product images, patient videos and more.