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心脏性猝死的预防:从可穿戴设备到皮下植入式心律转复除颤器

Prevention of sudden cardiac death: from wearable to subcutaneous cardioverter defibrillator.

作者信息

Viani Stefano, Soldati Ezio, DI Cori Andrea, Segreti Luca, Paperini Luca, DE Lucia Raffaele, Zucchelli Giulio, Bongiorni Maria G

机构信息

Unit of Cardiology, Department of Cardiothoracic and Vascular Surgery, University Hospital of Pisa, Pisa, Italy -

Unit of Cardiology, Department of Cardiothoracic and Vascular Surgery, University Hospital of Pisa, Pisa, Italy.

出版信息

Minerva Cardioangiol. 2018 Feb;66(1):83-99. doi: 10.23736/S0026-4725.17.04468-1. Epub 2017 Jul 10.

Abstract

The implantable cardioverter defibrillator (ICD) is today an indisputable evidence-based treatment for cardiac sudden death both in primary and secondary prevention. However many clinical conditions that would represent an indication to ICD implantation, according to guidelines, may be potentially reversible or may be accompanied by temporary contraindications to the implant. Moreover transvenous cardioverter defibrillator implantation still carries a not negligible risk of complications both acutely and at follow-up. The Wearable Cardioverter Defibrillator and the Subcutaneous Defibrillator are two recently developed technologies that can potentially overcome the aforementioned limitations of traditional transvenous ICDs. This review will discuss the main aspects of these 2 technologies, the data coming from clinical experiences and future perspectives.

摘要

植入式心脏复律除颤器(ICD)如今在心脏性猝死的一级和二级预防中,是一种无可争议的循证治疗方法。然而,根据指南,许多可作为ICD植入指征的临床情况可能具有潜在可逆性,或可能伴有植入的临时禁忌症。此外,经静脉心脏复律除颤器植入在急性期和随访期仍存在不可忽视的并发症风险。可穿戴式心脏复律除颤器和皮下除颤器是最近开发的两项技术,它们有可能克服传统经静脉ICD的上述局限性。本综述将讨论这两项技术的主要方面、来自临床经验的数据以及未来前景。

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