In summary, the article by Russo et al provides data for (the few percent of patients with a safety factor <10 J) and against (the similar mortality rates regardless of testing) the need for inducing VF and giving defibrillation shocks during ICD placement. In addition to ensuring a 10-J safety margin, however, there are other reasons to perform shock testing not touched upon in the article by Russo et al. These reasons include identifying lead dysfunction, demonstrating appropriate sensing, and testing system integrity to detect the rare case of device failure. At the present time, we believe the balance of considerations still tilts in favor of shock testing. It remains to be seen if newer devices and more data will tilt the balance in the other direction. © Heart Rhythm Society. All rights reserved.