Background:
A subcutaneous implantable cardioverter-defibrillator is an alternative for the patients who require ICD implantation for sudden cardiac death prevention and who present contraindications for the traditional intravenous lead implantation like high risk of infection. Yet, this device present disadvantage – incapacity of heart pacing.

Material and methods:
In this paper we present a series of four patients, the first in our clinic, who have been implanted with S-ICD.

Results:
Each of them presented different indications for S-ICD implantation – increased risk of infection due to infective endocarditis and diabetes, increased risk of infection due to dialysis and catheter infection, anatomical impossibility to implant T-ICD and prevention from long-time T-ICD complications.

Conclusions:
The implantations were successful, patients are currently under follow-up. These cases show that S-ICD device in a certain group of patients is a reasonable alternative, especially when pacing therapy is not necessary.