SICD Implantation Technique
For SICD device implantation, patients were placed in a supine position on the surgical table, with the left arm in an abducted position on an arm rest. There were three incisions made in total (Fig 1): left parasternal, sub-xiphoid in the midsagittal line, and inframammary along the anterior axillary line. The device was situated between the anatomic space between the serratus anterior and the latissimus dorsi muscles at the T 5-6 level. The distal tip of the electrode insertion tool was inserted at the xiphoid and tunneled laterally until the distal tip emerged in the device pocket. The electrode then was connected to the generator. The generator was fixed in the pocket with two separate sutures between the muscular fascia and the anchoring hole. The xiphoid incision site was also used to tunnel the lead cranially to reach the parasternal incision higher in the chest.