Anterolateral defibrillator pad placement is preferred with the lateral pad/pad- dle placed under the breast tissue, which is an important consideration in the pregnant patient. 3. The ICD in pregnant women is safe and For the rare circumstance of preg- nant women with an immediate indication for an ICD, or less common indications for VT ablation during pregnancy, the radiation risk to the fetus is The procedure is usually per- formed after the first trimester unless there are circumstances that demand an earlier procedure. Wearable cardioverter-defibrillators have been used in peripartum cardiomyopathy while await- ing repeat assessment of recovery of ventricular The subcutaneous implantable cardioverter-defibrillator is a potential alternative to conventional ICDs, although data are unavail- able to support a recommendation. 10.3. Older Patients With Comorbidities Recommendation for Older Patients With Comorbidities See Systematic Review Report.S10.3-1 COR LOE Recommendation IIa B-NRSR For older patients and those with significant comorbidities, who meet indications for a primary prevention ICD, an ICD is reasonable if meaningful survival of greater than 1 year SR indicates systematic review. Synopsis Refer to the Systematic Review for the 2017 ACC/ AHA/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death for the complete systematic evidence review for additional data and analyses.S10.3-1 The re- sults from the question What is the impact of ICD im- plantation for primary prevention in older patients and patients with significant comorbidities? (Part 2) and the writing committee s review of the totality of the lit- erature were used to frame our decision-making. Rec- ommendations are based on a body of evidence that includes the systematic review conducted by the ERC and are denoted by the superscript SR (eg, LOE: B-RSR ). 