S-ICD Extraction Procedure
All S-ICD extraction procedures were performed in an electrophysiology lab under general anesthesia, monitored anesthesia care, or conscious sedation. The patient was positioned in the same fashion as for S-ICD implantation. The generator was accessed by making an incision over the existing scar, and sharp or blunt dissection was performed until the generator was visualized. After the generator was disconnected from the lead, another incision was made over the subxiphoid scar to release the suture sleeve. If a three-incision technique was used for S-ICD implantation, a third incision was made over the superior sternum to release the distal lead suture. After all lead tie-down sutures were cut, the S-ICD was removed with manual traction. No transvenous lead extraction tools were required for successful removal. All incisions were closed in three layers following system extraction.