russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLC10.15829/1560-4071-2025-6485UJFXCArussjcardiol-6485Research ArticleСТАТЬИARTICLESСтимуляционная кардиомиопатия: современные критерии диагностики и стратификация риска (обзор литературы)Pacing-­induced cardiomyopathy: current diagnostic criteria and risk stratification (literature review)https://orcid.org/0000-0003-1294-9646ИловН. Н.IlovN. N.

Илов Николай Николаевич — профессор кафедры сердечно-­сосудистой хирургии, д.м.н., доцент; врач-сердечно-­сосудистый хирург отделения хирургического лечения сложных нарушений ритма сердца и электрокардиостимуляции.

ул. Бакинская, д. 121, Астрахань, 414000; ул. Покровская роща, д. 4, Астрахань, 414011

Bakinskaya str, 121, Astrakhan, 414000; Pokrovskaya Roscha str, 4, Astrakhan, 414011

nikolay.ilov@gmail.comhttps://orcid.org/0000-0001-8326-2644КаримовИ. Р.KarimovI. R.

Каримов Ильфат Рамилевич — врач-сердечно-­сосудистый хирург отделения хирургического лечения сложных нарушений ритма сердца и электрокардиостимуляции.

ул. Покровская роща, д. 4, Астрахань, 414011

Pokrovskaya Roscha str, 4, Astrakhan, 414011

karimov.ilfat16@yandex.ruФГБОУ ВО Астраханский ГМУ Минздрава России; ФГБУ "Феде­ральный центр сердечно-­сосудистой хирургии" Минздрава РоссииРоссияAstrakhan State Medical University; Federal Center for Cardiovascular SurgeryRussian FederationФГБУ "Феде­ральный центр сердечно-­сосудистой хирургии" Минздрава РоссииРоссияFederal Center for Cardiovascular SurgeryRussian Federation202525012026303SОбразование64856485Copyright © Илов Н.Н., Каримов И.Р., 20262026Илов Н.Н., Каримов И.Р.Ilov N.N., Karimov I.R.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/6485

Стимуляционная кардиомиопатия (СКМП) представляет собой форму приобретённой дисфункции левого желудочка, развивающуюся у части пациентов с высокой долей правожелудочковой стимуляции. В основе патогенеза лежит диссинхронная активация миокарда, приводящая к нарушению координации сокращений, региональной перегрузке, фиброзогенезу и ремоделированию левого желудочка. Обзор посвящён современным представлениям о диагностике СКМП, факторах риска и подходах к стратификации пациентов. Описаны предимплантационные, интра- и постимплантационные предик­торы СКМП. Отдельное внимание уделено новым неинвазивным методам визуализации и физиологическим стратегиям стимуляции, способным снизить риск развития СКМП. Подчёркивается важность мультифакторного подхода к диагностике, включая анализ клинико-­инструментальных данных, динамики фракции выброса, биомаркеров и параметров кардиостимуляции. Обзор акцентирует необходимость раннего выявления СКМП и индивидуализации тактики имплантации и наблюдения, что может способствовать улучшению прогноза и снижению частоты осложнений, связанных с длительной правожелудочковой стимуляцией.

Pacing cardiomyopathy (PICM) is a form of acquired left ventricular dysfunction that develops in some patients with a high proportion of right ventricular pacing. PICM pathogenesis is based on cardiac dyssynchrony, leading to impaired contractility, regional overload, fibrosis, and left ventricular remodeling. This review focuses on current concepts in the diagnosis of PICM, risk factors, and approaches to patient stratification. Pre-, intra-, and post-implantation predictors of PICM are described. Special attention is given to novel noninvasive imaging techniques and physiological pacing strategies that can reduce the risk of PICM. The importance of a multifactorial approach to diagnosis, including analysis of clinical and paraclinical data, changes in ejection fraction, biomarkers, and pacing parameters, is emphasized. The review focuses on the need for early detection of pacing-­induced cardiomyopathy and indivi­dualized implantation and monitoring strategies, which may improve prognosis and reduce the incidence of complications associated with long-term right ventricular pacing.

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