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. Areview 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. 398original publications were selected, of which 50original 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.