GlobalData forecasts the market value for implantable cardioverter defibrillators (ICDs) to reach $4.4bn by 2030 due to a predicted increasing incidence of sudden cardiac arrests from a growing ageing population globally. The ICD product portfolio is typically categorised into three subsegments: single-chamber, double-chamber, and subcutaneous ICDs.

Out of the three subsegments, double-chamber ICDs have historically had the highest market volume. Single-chamber ICDs feature a lower device cost than the other two segments. This may be an attractive temporary feature, but lower cost is not enough to help the segment gain more market share, as double-chamber ICDs are typically associated with a higher quality of life.

When comparing subcutaneous versus double-chamber ICDs, subcutaneous ICDs have been growing more aggressively at a compound annual growth rate (CAGR) of 14% from 2022 to 2033, while double-chamber ICDs have been growing at a CAGR of 8%. While double-chamber ICDs have been available on the market for 15+ years longer than subcutaneous ICDs, minimally invasive procedures have been gaining popularity.

The global ICD market is currently dominated by four key players: Medtronic, Abbott, Boston Scientific and Biotronik. Medtronic has the highest market share at 40% and is the leading manufacturer of single-chamber and double-chamber ICDs. Boston Scientific is the only market player in the subcutaneous ICD market, and therefore possesses 100% of the market share in the subcutaneous market.

As a result of the increasing appeal for minimally invasive procedures, Boston Scientific has been gaining market share from Medtronic due to being the only company in the subcutaneous ICD space. To counteract this issue, Medtronic is developing its extravascular ICD product line, which seems to be competitive relative to Boston Scientific’s subcutaneous ICD.

Results from the pivotal extravascular ICD study look promising, as patients enrolled in this study had a defibrillation success rate of 98.7%. Medtronic just received the CE mark today (17 February), but is still waiting for FDA approval for its extravascular ICD system.