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2%) and shock impedance (66 Ohm, interquartile range 57-77). On multivariate analysis, the 2-incision technique was associated with a lower incidence of shock failure (hazard ratio 0.305; 95% confidence interval 0.102-0.907; p = .033). Shock impedance was lower with the IM than with the SC approach (66 vs. 70 Ohm p = .002) and with the 2-incision than the 3-incision technique (67 vs. 72 Ohm; p = .006). In a large population of S-ICD patients, we observed a high defibrillation success rate. The IM + 2-incision technique provides lowe