russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLC10.15829/1560-4071-2023-5437russjcardiol-5437Research ArticleМНЕНИЕ ПО ПРОБЛЕМЕOPINION ON THE ISSUEОдноэлектродная система имплантируемого кардиовертера-дефибриллятора DX с флотирующим предсердным диполем: когда, кому и почему?DX single-lead implantable cardioverter-defibrillator system with a floating atrial dipole: when, to whom, and why?https://orcid.org/0000-0002-9686-6583ПрокопенкоА. В.ProkopenkoA. V.

Врач кардиолог КХО № 2

Красноярск

Krasnoyarsk

aleksandra1001@gmail.comhttps://orcid.org/0000-0002-4946-8005ИваницкийЭ. А.IvanitskyE. A.

Доктор медицинских наук, заведующий отделением КХО № 2

Красноярск

Krasnoyarsk

ФГБУ Федеральный центр сердечно-сосудистой хирургииРоссияFederal Center for Cardiovascular SurgeryRussian Federation20232104202328554375437Copyright © Прокопенко А.В., Иваницкий Э.А., 20232023Прокопенко А.В., Иваницкий Э.А.Prokopenko A.V., Ivanitsky E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://russjcardiol.elpub.ru/jour/article/view/5437

В статье отражена информация, предназначенная для врачей кардиологов, кардиохирургов, врачей, программирующих имплантированные антиаритмические устройства, сотрудников и ординаторов кафедр кардиологии и кардиохирургии. Чаще всего мы стремимся выбрать модель имплантируемого кардиовертера-дефибриллятора (ИКД) строго индивидуально для каждого пациента, исходя из особенностей его анамнеза, безопасности и наибольшей эффективности предложенных на рынке систем ИКД. Компании-производители с каждой новой моделью ИКД стремятся минимизировать количество имплантируемых компонентов и разработать более совершенные алгоритмы дискриминации предсердных тахиаритмий от истинных желудочковых в борьбе за уменьшение количества неуместных шоковых разрядов. Однако опасность неуместной ИКД-терапии по-прежнему остается высокой. Так, лечащие врачи и кардиологи, программирующие имплантируемые антиаритмические устройства, часто сталкиваются с трудностями коррекции настроек ИКД и планированием дальнейшего лечения пациента с шоками, нанесенными на предсердные тахиаритмии. Авторы стремились сформировать у целевой аудитории представление об особенностях работы однокамерного ИКД с возможностью регистрации предсердных потенциалов при помощи флотирующего диполя встроенного в тело дефибриллирующего электрода, о преимуществах системы DX перед классическими однокамерными системами ИКД и "нарисовать" портрет пациента, для которого данный тип имплантируемой системы являлся бы оптимальным выбором в борьбе за профилактику фатального нарушения ритма сердца.

The article reflects information for cardiologists, cardiac surgeons, doctors pro­gramming implanted antiarrhythmic devices, employees and residents of the depart­ments of cardiology and cardiac surgery. Most often, we choose a model of an implantable cardioverter-defibrillator (ICD) strictly individually for each patient, based on the anamnesis characteristics, safety and highest efficiency of ICD systems offered on the market. With each new ICD model, manufacturing companies strive to minimize the number of implantable components and develop better algorithms to discriminate between atrial tachyarrhythmias and true ventricular tachyarrhythmias. However, the risk of inappropriate ICD therapy still remains high. Thus, attending physicians and cardiologists programming implantable antiarrhythmic devices often face difficulties in correcting ICD settings and planning further treatment of a patient with shocks caused by atrial tachyarrhythmias. The authors sought to form an idea about the features of a single-chamber ICD recording atrial potentials using a floating dipole, as well as the advantages of the DX system over classical single-chamber ICD systems, and to define a type of a patient for whom this implantable system would be the best choice preventing sudden cardiac death.

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The authors declare that there are no conflicts of interest present.