John Leah A, Karimianpour Ahmadreza, Gold Michael R
Division of Cardiology, Medical University of South Carolina Charleston, SC.
US Cardiol. 2021 Oct 21;15:e19. doi: 10.15420/usc.2021.01. eCollection 2021.
The ICD is an important therapy in the prevention of sudden cardiac death. The transvenous-ICD (TV-ICD) has been the primary device used for this purpose. However, mechanical and infectious complications occur with traditional TV-ICDs increasing morbidity and mortality. The subcutaneous-ICD (S-ICD) system was developed to circumvent some of these complications, but S-ICDs have their inherent set of limitations as well. These include inappropriate shock delivery, lack of bradycardia, antitachycardia or CRT pacing therapy and shorter device longevity. The S-ICD is now included in guidelines as an acceptable alternative to TV-ICDs among patients without pacing indications. This review discusses the rationale for S-ICDs by reviewing studies including the PRAETORIAN, PAS, and UNTOUCHED trials.
植入式心律转复除颤器（ICD）是预防心源性猝死的重要治疗手段。经静脉植入式心律转复除颤器（TV-ICD）一直是用于此目的的主要设备。然而，传统TV-ICD会出现机械和感染并发症，增加发病率和死亡率。皮下植入式心律转复除颤器（S-ICD）系统的开发是为了规避其中一些并发症，但S-ICD也有其固有的局限性。这些局限性包括不适当的电击发放、缺乏心动过缓、抗心动过速或心脏再同步治疗（CRT）起搏治疗以及设备使用寿命较短。S-ICD现在已被纳入指南，作为无起搏指征患者中TV-ICD的可接受替代方案。本综述通过回顾包括PRAETORIAN、PAS和UNTouched试验在内的研究，讨论了S-ICD的基本原理。
