Lambiase Pier D, Srinivasan Neil T
The Heart Hospital, University College Hospital & Institute of Cardiovascular Sciences, UCL, 16-18 Westmoreland Street, London, W1G 8PH, UK,
Curr Cardiol Rep. 2014 Aug;16(8):516. doi: 10.1007/s11886-014-0516-1.
The Subcutaneous Internal Cardiac Defibrillator (S-ICD) represents a major advance in the care of patients who have an indication for an internal cardiac defibrillator without pacing indications. Its main advantage is that it can deliver a shock to cardiovert ventricular arrhythmias utilising a tunnelled subcutaneous lead, negating the risks associated with conventional transvenous systems. Initial studies have shown comparable efficacy in cardioversion of induced and spontaneous ventricular tachycardia (VT) and ventricular fibrillation (VF) when compared to conventional transvenous systems. In addition, inappropriate shocks occurred in a similar percentage of patients to conventional ICD studies. Complication rates are low and relate largely to localised wound infections, treated successfully with antibiotics. The long term efficacy of the device is yet to be ascertained, however, a randomised trial & prospective registries are currently in progress to enable direct comparison with transvenous ICDs. This article summarises the early clinical experience and trials in the implantation of the S-ICD.
皮下植入式心脏除颤器（S-ICD）代表了在无起搏指征但有植入心脏除颤器指征的患者护理方面的一项重大进展。其主要优点是，它可以通过一根经皮下隧道的导线输送电击以转复室性心律失常，消除了与传统经静脉系统相关的风险。初步研究表明，与传统经静脉系统相比，在转复诱发性和自发性室性心动过速（VT）及室颤（VF）方面具有相当的疗效。此外，不适当电击的发生率与传统植入式心脏除颤器研究中的患者比例相似。并发症发生率较低，主要与局部伤口感染有关，使用抗生素治疗可成功治愈。然而，该装置的长期疗效尚未确定，目前正在进行一项随机试验和前瞻性注册研究，以便能与经静脉植入式心脏除颤器进行直接比较。本文总结了S-ICD植入的早期临床经验和试验情况。
