Was anyone here given the choice of ICD vs S-ICD. I have to choose.

I've had an ICD for 25 years and any time my heart went into arrhythmia the ICD adjusted it, it felt like a tap and everything was fine.

@mary2249 I should say my ICD is not with pacemaker.

@stevekayakman
I have had a dual (ICD/Pacemaker) device since 2006. Back in 2006 my local cardiologist where I lived back then said he was referring me to a electrophysiologist (EP) for a ICD as my EF had reached 30 bpm.

I decided to get second opinion at Mayo Jacksonville where the EP recommended both ICD and Pacemaker a dual device. I had a LBBB but I am glad he recommended both. When my Mayo HF specialist put me on Entresto and Carvedilol my pulse rate went down into 40s. A low PR can cause arrythmias.

The EP and pace clinic adjusted my pacemaker to pace me at 50, then 60, then 70 and has been at 70 for 10 years. Why raising. It was to find a good pulse rate that helped reduce PVCs.

A pacemaker will pulse your heart at a programmed rate and degree based on what you need. If you don't need pacing it does not pace. But if you do like I did it will pace you. So without a pacemaker your ICD will not pace your heart if you take medication like I did which drastically lower you pulse rate.

An ICD does not pace your heart to maintain a steady rhythm nor bring the BPM up to safe levels if it drops below a programmed level. An ICD is there to provide a shock to your heart when it goes into VTAC.

I have now been a patient at Mayo Jacksonville for over 20 years seeing both a EP and HF doctors as well as many other specialists. I am only here writing this because I had the ICD/Pacemaker implanted back in 2006

I have both and am happy. Why not opt for more coverage vs. less?
I would look into the downside you mention you learned about. Verify it, and if true, check into stats- percentage of incidents for users.
If it were truly a troublesome risk, I doubt that the ICD/pacemaker combo would be so widely used.

I see you have been following Comment for a long time and yesterday you posted your first question. Welcome! I have an ICD (named Buddy) that was installed a few months after a septal myectomy, I developed arrythemias and had 2 syncope before the cardiologists could figure out the cause, the pacing made my arrythemias nonexistant. It was an electrical problem arising from the trama my very lucky heart experienced. It sets the rhythm, without the ICD, the rhythm was irregular and caused dangerous problems. No shocks so far. @jc76 wrote an excellent explanation and I encourage you to ask your EP (electrophysiologist) and cardiologist team to comment on your concern. In studies, if 10,000 people are subjects and one person experiences a side effect, it's reported, hopefully with the percentage of time it was observed. BTW, one of the items we mentors have been discussing is the use of acronyms. We observed that not everyone knows what the letters stand for. I wonder if we can start a trend: The first trime you use the letters, put the meaning in ( ). @jc76 did for BP and EP. Let's see if we can do that to help others better understand our messages.

My understanding of ICD and S-ICD (I only have a pacemaker) is that one is just under the skin (S=subcutaneous) and one is in the heart. The ICD is more traditional, according to what I read. Personally, I prefer to go newer, which is why I waited until the pulsed field ablation was offered.