Subcutaneous implantable cardioverter/defibrillators (S-ICDs) have been developed to offer ICD treatment to patients without venous access to the heart and to overcome complications associated with transvenous leads, particularly lead fracture/insulation defects and endocarditis. Several studies and registries have demonstrated the feasibility and safety of S‑ICD in different groups of patients. Further developments in S‑ICD technology involve the combination with devices that can provide anti-bradycardia and anti-tachycardia pacing if needed. The extravascular ICD (EV-ICD) is a new system that similarly offers ICD therapy without a transvenous lead but uses a substernal instead of a subcutaneous lead to facilitate detection of ventricular fibrillation and to provide anti-tachycardia and also temporary anti-bradycardia pacing. The first animal but also clinical data on EV-ICDs have been published. This review discusses the current state, potential advantages and limitations, and future research of both S‑ICD and EV-ICD.

皮下植入式心脏复律器/除颤器 (S-ICD) 的开发旨在为无法通过静脉进入心脏的患者提供 ICD 治疗，并克服与经静脉导线相关的并发症，尤其是导线断裂/绝缘缺陷和心内膜炎。多项研究和注册证明了 S‑ICD 在不同患者组中的可行性和安全性。S‑ICD 技术的进一步发展涉及与可在需要时提供抗心动过缓和抗心动过速起搏的设备的组合。血管外 ICD (EV-ICD) 是一种新系统，它同样提供 ICD 治疗，无需经静脉导线，但使用胸骨下导线代替皮下导线，以促进心室颤动的检测并提供抗心动过速和临时抗心动过缓起搏。EV-ICD 的第一个动物数据和临床数据已经发表。本综述讨论了 S-ICD 和 EV-ICD 的现状、潜在优势和局限性以及未来的研究。