Implantation of an Extravascular Implantable Defibrillator Using a Substernal Lead in a Patient with Previous Cardiac Surgery

We present the case of a 52-year-old man suffering from malignant mitral valve prolapse syndrome. He underwent a right-sided thoracotomy for mitral valve repair but required implantable cardioverter-defibrillator (ICD) implantation 4 years later. He chose the option of a substernal ICD, which was implanted successfully without any complications and good electrical parameters.