Division of Cardiology, Medical University of South Carolina, 114 Doughty Street, MSC 592, Charleston, SC 29425-5920, USA.
Nat Rev Cardiol. 2015 Jul;12(7):398-405. doi: 10.1038/nrcardio.2015.56. Epub 2015 Apr 21.
The subcutaneous implantable cardioverter-defibrillator (S-ICD) is a novel technology for the treatment of sudden cardiac death. The system consists of a pulse generator implanted in the left axillary position and a single subcutaneous lead for detection and delivery of therapy. Initial clinical trials of S-ICDs demonstrated improved safety and efficacy when compared to transvenous ICD systems, leading to their widespread approval. The main advantage of the S-ICD is the avoidance of vascular access and the complications associated with transvenous leads. Owing to limitations of S-ICDs, patients who require pacing support or antitachycardia pacing are not candidates for the device; instead, this system is currently used most commonly in young patients with previous lead malfunction, limited vascular access, or low risk for subsequent bradycardia or antitachycardia pacing. Findings from device trials support S-ICDs as a viable alternative to transvenous ICDs in certain patients, and the current limitations associated with S-ICDs are likely to be addressed in future iterations of the device, extending its indications and target patient populations.
皮下植入式心律转复除颤器（S-ICD）是一种治疗心源性猝死的新型技术。该系统由一个植入左腋窝位置的脉冲发生器和一个用于检测和传递治疗的单个皮下导联组成。S-ICD 的初步临床试验显示与经静脉 ICD 系统相比，其具有更高的安全性和有效性，从而得到了广泛的批准。S-ICD 的主要优势在于避免了血管通路以及与经静脉导联相关的并发症。由于 S-ICD 的局限性，需要起搏支持或抗心动过速起搏的患者不适合使用该设备；相反，该系统目前最常用于以前存在导联故障、血管通路有限或随后发生心动过缓或抗心动过速起搏风险较低的年轻患者。设备试验结果支持 S-ICD 作为某些患者替代经静脉 ICD 的可行选择，并且未来 S-ICD 的迭代版本可能会解决与该设备相关的当前限制，从而扩大其适应证和目标患者人群。
