Utility and feasibility of intra-pocket mapping technique for optimal subcutaneous implantable cardioverter defibrillator implantation positioning for R-wave detection: a case series

These cases highlight the utility of intra-pocket mapping to optimize S-ICD positioning for R-wave detection in patients with challenging electrocardiogram characteristics. Posterior chest positioning may not be optimal for R-wave detection, particularly in patients with low R-wave and/or high T-wave amplitudes. Repositioning the device closer to the left ventricular apex improved sensing test results, supporting antero-inferior chest placement as a potential solution when posterior chest placement fails.