First case of pregnancy and childbirth in a patient implanted with an extravascular implantable cardioverter-defibrillator

The extravascular implantable cardioverter-defibrillator (EV-ICD) was developed as an extravascular alternative to the transvenous ICD (TV-ICD).1 In contrast to the already commercially available subcutaneous ICD (S-ICD), the lead of the EV-ICD is implanted in the substernal space, enabling it to deliver anti-tachycardia and pause-prevention pacing.2 Due to the close proximity to the heart, the EV-ICD has a proven lower defibrillation threshold than the S-ICD and the generator size is therefore comparable to a transvenous device, with an output of 40J.