Division of Cardiology, Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, United States of America.
Division of Cardiology, Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, United States of America.
Prog Cardiovasc Dis. 2019 May-Jun;62(3):249-255. doi: 10.1016/j.pcad.2019.04.003. Epub 2019 Apr 18.
The implantable cardioverter-defibrillator (ICD) has been successfully treating patients with lethal ventricular arrhythmias for decades. The main acute and chronic complications of this therapy modality are related to the use of a transvenous lead. An entirely extravascular ICD concept was developed over the last 20 years, with emergence of the subcutaneous ICD (S-ICD). This device was approved for clinical use seven years ago, and accumulating real-life experience confirms its safety and efficacy. The main limitations related to this system include the lack of pacing capabilities for bradycardia, tachycardia or resynchronization therapy, a large size, and relatively high energy requirements for effective defibrillation. This review article summarizes current knowledge and potential future developments of the extravascular ICD technologies.
植入式心脏复律除颤器 (ICD) 已经成功治疗了几十年致命性室性心律失常患者。这种治疗方式的主要急性和慢性并发症与经静脉导联的使用有关。二十多年来，人们开发了一种完全血管外的 ICD 概念，即皮下 ICD（S-ICD）。该设备在七年前获得了临床应用批准，不断积累的真实经验证实了其安全性和有效性。与该系统相关的主要限制包括缺乏用于心动过缓、心动过速或再同步治疗的起搏功能、体积较大以及有效除颤的能量要求相对较高。本文综述了血管外 ICD 技术的当前知识和潜在的未来发展。
