Department of Clinical and Molecular Medicine, Sapienza University, St Andrea Hospital, Rome, Italy.
Arrhythmia & EP Research Center, IRCCS Humanitas Research & University Hospital, Rozzano, Milan, Italy.
Eur J Intern Med. 2019 Jul;65:6-11. doi: 10.1016/j.ejim.2019.04.003. Epub 2019 Apr 17.
The subcutaneous implantable cardioverter defibrillator (S-ICD) is a valuable alternative to the conventional trans-venous ICD (TV-ICD) for the prevention of sudden cardiac death (SCD). Prospective registries showed that the S-ICD is safe and effective in treating ventricular tachyarrhythmias in high-risk patients without pacing indications. While in earlier studies patients implanted with S-ICDs were young and mostly affected by channelopathies, contemporary S-ICD cohorts include patients with severely impaired left ventricular function and significant comorbidities. This review focuses on S-ICD evidence-based use and highlights current gaps between guidelines recommendations and real-world clinical practice.
皮下植入式心律转复除颤器（S-ICD）是一种有价值的替代传统经静脉植入式心律转复除颤器（TV-ICD）的方法，可预防心源性猝死（SCD）。前瞻性注册研究表明，S-ICD 在治疗无起搏适应证的高危患者的室性心动过速方面是安全有效的。虽然在早期研究中，植入 S-ICD 的患者较为年轻，且主要受通道病的影响，但当代 S-ICD 队列包括左心室功能严重受损和合并症较多的患者。本综述重点关注 S-ICD 的循证应用，并强调指南推荐与真实世界临床实践之间的当前差距。
