Features of subcutaneous cardioverter-defibrillators implantation

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Abstract

According to global statistics, 25% of deaths every year are cases of sudden cardiac death. Implantation of cardioverter-defibrillators is currently used as its prevention. In the coming years, the world is projected to see an increase in the number of implantations of cardioverter-defibrillators in high-income countries, as well as an expansion of the range of medical devices offered, including subcutaneous cardioverter-defibrillators, which are currently being considered as a promising alternative. We systematized the literature data presented in various international studies evaluating the efficacy and safety of the use of subcutaneous cardioverter-defibrillators. A review of the medical literature published in the period from 2015 to 2022 was carried out using the information and analytical systems MEDLINE, Scopus, Clinicaltrials.gov, Google Scholar and Web of Science. The review was performed in accordance with the checklist of preferred reporting items for systematic reviews and meta-analyses. 398 original publications were selected, of which 50 original scientific articles on the research topic were included in the analysis. Modern international studies have demonstrated the efficacy and safety of the use of subcutaneous implantable cardioverter defibrillators. An improvement in the performance of unmotivated discharges over time was noted, which was associated with the improvement of implantable cardioverter-defibrillators. The operating time for implantation of subcutaneous cardioverter-defibrillators was significantly less compared to transvenous cardioverter-defibrillators. Subcutaneous cardioverter-defibrillators were associated with a lower incidence of perioperative complications and high efficacy of shock therapy. Subcutaneous cardioverter-defibrillators were as effective as transvenous implantable cardioverter-defibrillators and did not have the risk of complications associated with implantation of endocardial electrodes. The main limitations of the technique were the impossibility of pacing and the absence of antitachycardic stimulation.

About the authors

Anar Yu. Amiraslanov

Scientific Medical Research Center of Surgery named after A.V. Vishnevsky

Author for correspondence.
Email: anar_amiraslanov@list.ru
ORCID iD: 0000-0002-3405-1063

M.D., D. Sci. (Med.), Cardiovascular Surgeon

Russian Federation, Moscow, Russia

Elena A. Artyukhina

Scientific Medical Research Center of Surgery named after A.V. Vishnevsky; Russian Medical Academy of Continuous Professional Education

Email: artelena.71@mail.ru
ORCID iD: 0000-0001-7065-0250

M.D., D. Sci. (Med.), Head of the Depart., Depart. of Electrophysiological X-Ray Endovascular Methods for Diagnosis and Treatment of Arrhythmias; Prof., Depart. of Angiology, Cardiovascular, Endovascular Surgery and Arrhythmology

Russian Federation, Moscow, Russia; Moscow, Russia

Amiran Sh. Revishvili

Scientific Medical Research Center of Surgery named after A.V. Vishnevsky; Russian Medical Academy of Continuous Professional Education

Email: vishnevskogo@ixv.ru
ORCID iD: 0000-0003-1791-9163

M.D., D. Sci. (Med.), Prof., Academician of the Russian Academy of Sciences, Head; Head of the Depart., Depart. of Angiology, Cardiovascular, Endovascular Surgery and Arrhythmology

Russian Federation, Moscow, Russia; Moscow, Russia

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2. Рис. 1. А. Позиционирование системы подкожного имплантируемого кардиовертера-дефибриллятора. Направления векторов восприятия желудочковой аритмии. Первичный: от проксимального полюса электрода до корпуса. Вторичный: от дистального полюса электрода до корпуса. Альтернативный: от дистального до проксимального полюса электрода; a — дистальный полюс электрода; б — проксимальный полюс электрода. Б. Дефибрилляционный тест. Индукция и эффективное купирование фибрилляции желудочков шоковым разрядом. В. Рентгеноскопия системы подкожного имплантируемого кардиовертера-дефибриллятора. Прямая проекция. Г. Левая проекция.

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3. Рис. 2. Годовая частота немотивированных шоков кардиовертеров-дефибрилляторов по данным крупных исследований. П-ИКД — подкожный имплантируемый кардиовертер-дефибриллятор; ТВ-ИКД — трансвенозный имплантируемый кардиовертер-дефибриллятор

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3. Цель обработки персональных данных: анализ пользовательской активности с помощью сервиса «Яндекс.Метрика».

4. Категории субъектов персональных данных: все Пользователи Сайта, которые дали согласие на обработку файлов «cookie».

5. Способы обработки: сбор, запись, систематизация, накопление, хранение, уточнение (обновление, изменение), извлечение, использование, передача (доступ, предоставление), блокирование, удаление, уничтожение персональных данных.

6. Срок обработки и хранения: до получения от Субъекта персональных данных требования о прекращении обработки/отзыва согласия.

7. Способ отзыва: заявление об отзыве в письменном виде путём его направления на адрес электронной почты Оператора: info@rcsi.science или путем письменного обращения по юридическому адресу: 119991, г. Москва, Ленинский просп., д.32А

8. Субъект персональных данных вправе запретить своему оборудованию прием этих данных или ограничить прием этих данных. При отказе от получения таких данных или при ограничении приема данных некоторые функции Сайта могут работать некорректно. Субъект персональных данных обязуется сам настроить свое оборудование таким способом, чтобы оно обеспечивало адекватный его желаниям режим работы и уровень защиты данных файлов «cookie», Оператор не предоставляет технологических и правовых консультаций на темы подобного характера.

9. Порядок уничтожения персональных данных при достижении цели их обработки или при наступлении иных законных оснований определяется Оператором в соответствии с законодательством Российской Федерации.

10. Я согласен/согласна квалифицировать в качестве своей простой электронной подписи под настоящим Согласием и под Политикой обработки персональных данных выполнение мною следующего действия на сайте: https://journals.rcsi.science/ нажатие мною на интерфейсе с текстом: «Сайт использует сервис «Яндекс.Метрика» (который использует файлы «cookie») на элемент с текстом «Принять и продолжить».