Aim. Evaluate the overall effectiveness of cardiac contractility modulation (CCM) therapy in patients with chronic heart failure of various etiology.Methods. The study included 61 patients with chronic heart failure (NYHA class II-III), ejection fraction 20-40% and narrow QRS <130 ms, who were implanted the CCM devices. Depending on the etiology of heart failure, ischemic cardiomyopathy prevailed (41 patients). All patients were performed echocardiography, 6-min walk test and Minnesota Living with Heart Failure questionnaire (MHFLQ). Results. The observation period was 25 months. All 54 patients significantly improved left ventricular ejection fraction from 32.2% to 37.6% (р=0.026) and volume parameters (left ventricle end systolic volume from 150 to 137 ml (р=0.034), left ventricle end diastolic volume from 220 to 201 ml (р=0.044), reduced the heart failure NYHA class >1 in 29 (53.7%) patients (р=0.015), increased 6-min walk test from 265 to 343 m (р=0.029), and the MHFLQ improved from 46.1 to 35.8 (р=0.042). Non-ischemic cardiomyopathy was associated with significant improvement in MHFLQ (from 42.7 to 30.3, р=0.029) and lowering the heart failure NYHA class>1 (83.3%, vs 47.2%, p=0.012) compared to ischemic group. Conclusion. CCM is safe and effective in patients with chronic heart failure NYHA class II-III, ejection fraction 20- 40% and narrow QRS˂130 ms, who were implanted the CCM devices. Depending on the etiology of heart failure, ischemic cardiomyopathy prevailed (41 patients). All patients were performed echocardiography, 6-min walk test and Minnesota Living with Heart Failure questionnaire (MHFLQ).Results. The observation period was 25 months. All 54 patients significantly improved left ventricular ejection fraction from 32.2% to 37.6% (р=0.026) and volume parameters (left ventricle end systolic volume from 150 to 137 ml (р=0.034), left ventricle end diastolic volume from 220 to 201 ml (р=0.044), reduced the heart failure NYHA class >1 in 29 (53.7%) patients (р=0.015), increased 6-min walk test from 265 to 343 m (р=0.029), and the MHFLQ improved from 46.1 to 35.8 (р=0.042). Non-ischemic cardiomyopathy was associated with significant improvement in MHFLQ (from 42.7 to 30.3, р=0.029) and lowering the heart failure NYHA class>1 (83.3%, vs 47.2%, p=0.012) compared to ischemic group.Conclusion. CCM is safe and effective in patients with chronic heart failure NYHA class II-III, ejection fraction 20- 40% and narrow QRS˂130 ms. Non-ischemic etiology of cardiomyopathy was associated with significant improvement in MHFLQ and lowering the heart failure class.

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.

There is the first clinical use of POLARx cryoballoon catheter for pulmonary vein isolation in patients with atrial fibrillation in Russian Federation.

Системы удаленного мониторинга (УМ) работы имплантированных антиаритмических устройств становятся распространенным методом контроля функционирования с возможностью регистрации аритмии и передачи данных врачу, наряду с плановыми проверками в медицинских учреждениях. Важно информировать пациентов о возможных внеочередных посещениях клиники и необходимости телефонной связи с врачом. В представленном ниже клиническом случае пациент, не ощутив шокового разряда имплантированного кардиовертера-дефибриллятора (ИКД), не связался с клиникой. Полученное врачом оповещение и последующий анализ данных УМ устройства позволили выявить и своевременно устранить дислокацию дефибрилляционного электрода в условиях стационара. Ключевые слова:удаленный мониторинг, имплантируемый кардиовертер-дефибриллятор, желудочковая тахикардия, фибрилляция предсердий. Конфликт интересов:авторы заявляют об отсутствии конфликта интересов. Прозрачность финансовой деятельности:никто из авторов не имеет финансовой заинтересованности в представленных материалах или методах. Соответствие принципам этики:пациент, представленный в описании данного клинического случая, дал информированное согласие на проведение диагностических и лечебных мероприятий.