Heart specialists at the Washington University and Barnes-Jewish Heart & Vascular Center were the first in Missouri to implant a subcutaneous implantable cardioverter defibrillator (S-ICD) into a patient during a procedure that took place on Friday, Nov. 29. Unlike the traditional ICD used to help treat arrhythmias such as tachycardia, the S-ICD does not place wires inside the heart or blood vessels.