Subglandular placement of an implantable cardioverter-defibrillator for an improved cosmetic outcome

Implantable cardioverter-defibrillator (ICD) technology has progressed through the years decreasing the size of the device, and its effectiveness in preventing sudden cardiac death has made it a mainstay of treatment for many patients. As the use of ICDs in younger patients has increased, issues with placement of an ICD in the usual prepectoral, infraclavicular region have arisen. Subglandular placement through an inframammary incision provides a unique approach and an aesthetically pleasing outcome for ICD placement. We present a review of the current literature and 3 cases of young female patients who had placement of an ICD using this approach.