At the Telco I worked at for 34 years we used Joslyn brand (made in the USA) surge protection. They used field replaceable huge MOV's..and also field replaceable large style cartridge fuses.
Each MOV is fused with the fuse inside the MOV box assy...which resides just below the main panel. At the output of each fuse, it feeds 120 vac into the input of the MOV....and also to the input of a NEON...and also the input relay coil of a 4PDT relay. At main panel end, they use a 2 x pole breaker (single phase)...or a 3 x pole breaker (3 phase).
The relay is energized 24/7. When MOV's fail, they always fail..shorted. When the MOV shorts, the fuse blows open, and the NEON goes out (no longer illuminated). The relay coil no longer has any 120 vac, and it drops out. When the relay drops out, it puts a ground onto the alarm lead..... which brings in an alarm at the main alarm monitoring NOC.
(network operations center).
For small sites, like cell sites, that run on 240/120 vac.... only 2 x MOV's used, only 2 x NEONS....and only 2 x 4PDT relays. In main central offices, which use 208/120 vac 3 phase power, 3 x mov's used, 3 NEONS..and 3 x 4PDT relays.
MOV's are always wired hot to neutral..... ditto with NEONS and relay coils.
We have thousands of these Joslyn lightning protectors in use. Never lost any equipment from surges, spikes, hiccups, transients etc...not during my tenure.
The newer versions use LED's instead of Neon's. Other than that, zero difference.
Always installed at the main panel. Neutral and grnd are bonded together in the main panel. Typ external ground setup
consisted of 10'/20' copper ground rods, every 10'/20' around the perimeter of the building, and all CAD welded below ground, all wiring also below ground level. (none of it is visible).
The whole house protection devices appear to be similar, minus the alarm relay. I'm told that in some parts of Florida, insurance companies will mandate their use. In some cases, the entire MOV assy is external...next to the power meter, so the power company can see that one / both LEDS are out....and the power company can field replace the shorted MOV(S) and mating cartridge fuses.
I would recommend the whole house protection scheme for residential use. Their service life is indefinite. They just sit there...till something bad happens. Cheap insurance, vs blowing up stuff in your home..and hassling with insurance companies. (did the fridge just crap out, or did a transient / surge take out the fridge, prove it, pretty tough to prove).