Combination of a leadless pacemaker and subcutaneous implantable cardioverter defibrillator therapy for a Japanese patient with prosthetic valve endocarditis.

The subcutaneous implantable cardioverter defibrillator (S-ICD) system was developed for defibrillation therapy that does not affect the heart and vasculature. S-ICD is preferred over transvenous ICD for patients with a history of recurrent infection presenting with life-threatening rhythms. Patients with bradycardia pacing indications are excluded from S-ICD therapy, as S-ICD lacks the capability of defibrillation in this patient group. Implantation of an S-ICD with a leadless pacemaker (LP) was proposed to overcome this issue. We describe the first case of successful implantation of S-ICD and LP in a Japanese patient with a history of recurrent prosthetic valve endocarditis.