An entirely subcutaneous implantable cardioverter-defibrillator (ICD; S-ICD® system, Cameron Health, Inc., USA) performs as well, and is associated with a similar rate of clinical events, as conventional transvenous ICDs according to a new study. The EFFORTLESS-ICD registry represents the first international dataset on the use of subcutaneous ICDs in general practice. The overall conversion efficacy for spontaneous arrhythmic episodes was 96.1% (95% CI 90.8–100%), with 88% terminated effectively on first shock, and a 100% success rate after a maximum of five shocks. The annual rate of inappropriate shocks was 7%. The investigators believe that the S-ICD® could be “a new alternative to the conventional transvenous ICD system to minimize intravascular lead complications”.