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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">amedj</journal-id><journal-title-group><journal-title xml:lang="ru">Амурский медицинский журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Amur Medical Journal</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2311-5068</issn><publisher><publisher-name>Амурская государственная медицинская академия</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.22448/AMJ.2025.2.61-68</article-id><article-id custom-type="edn" pub-id-type="custom">MQWARJ</article-id><article-id custom-type="elpub" pub-id-type="custom">amedj-68</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>СЛУЧАЙ ИЗ ПРАКТИКИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CASE STUDY</subject></subj-group></article-categories><title-group><article-title>Комбинированный подход в лечении хронической сердечной недостаточности: имплантация подкожного кардиовертерадефибриллятора и устройства модуляции сердечной сократимости (клиническое наблюдение)</article-title><trans-title-group xml:lang="en"><trans-title>Combined Approach in the Management of Chronic Heart Failure: Implantation of a Subcutaneous Cardioverter-Defibrillator and a Cardiac Contractility Modulation Device (A Clinical Case)</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шульга</surname><given-names>А. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Shulga</surname><given-names>A. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Андрей Сергеевич Шульга - сердечно-сосудистый хирург, Клиника кардиохирургии</p><p>Благовещенск</p></bio><bio xml:lang="en"><p>Andrey S. Shulga</p><p>Blagoveshchensk</p></bio><email xlink:type="simple">mig2994@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Любенков</surname><given-names>К. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Lyubenkov</surname><given-names>K. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кирилл Аркадьевич Любенков - сердечно-сосудистый хирург, Клиника кардиохирургии</p><p>Благовещенск</p></bio><bio xml:lang="en"><p>Kirill A. Lyubenkov</p><p>Blagoveshchensk</p></bio><email xlink:type="simple">cyril.lubenkov@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Савченко</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Savchenko</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дмитрий Александрович Савченко - кардиолог, Клиника кардиохирургии</p><p>Благовещенск</p></bio><bio xml:lang="en"><p>Dmitry A. Savchenko</p><p>Blagoveshchensk</p></bio><email xlink:type="simple">dmitralsav@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Басанова</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Basanova</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Инна Владимировна Басанова - кардиолог, Клиника кардиохирургии</p><p>Благовещенск</p></bio><bio xml:lang="en"><p>Inna V. Basanova</p><p>Blagoveshchensk</p></bio><email xlink:type="simple">innabasanova@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">Федеральное государственное бюджетное образовательное учреждение высшего образования «Амурская государственная медицинская академия» Министерства здравоохранения Российской Федерации<country>Россия</country></aff><aff xml:lang="en">Amur State Medical Academy, Ministry of Healthcare of the Russian Federation<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>26</day><month>12</month><year>2025</year></pub-date><volume>13</volume><issue>2</issue><fpage>61</fpage><lpage>68</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Шульга А.С., Любенков К.А., Савченко Д.А., Басанова И.В., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Шульга А.С., Любенков К.А., Савченко Д.А., Басанова И.В.</copyright-holder><copyright-holder xml:lang="en">Shulga A.S., Lyubenkov K.A., Savchenko D.A., Basanova I.V.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.amedj.ru/jour/article/view/68">https://www.amedj.ru/jour/article/view/68</self-uri><abstract><p>Хроническая сердечная недостаточность (ХСН) остается одной из ведущих причин заболеваемости и смертности во всем мире. Несмотря на значительные успехи медикаментозной терапии, значительная доля пациентов с ХСН демонстрируют прогрессирование заболевания и сохраняющийся высокий риск внезапной сердечной смерти. Имплантируемые кардиологические устройства занимают центральное место в комплексном лечении ХСН, обеспечивая как профилактику фатальных аритмий, так и улучшение насосной функции сердца. Среди них особое значение имеют кардиовертеры-дефибрилляторы и устройства модуляции сердечной сократимости (МСС), которые воздействуют на разные патофизиологические звенья сердечной недостаточности.В статье представлено клиническое наблюдение пациента с ХСН и низкой фракцией левого желудочка. Первым этапом пациенту выполнена имплантация подкожной системы кардиовертера-дефибриллятора (S-ICD). Послеоперационный период протекал без особенностей. Вторым этапом пациенту имплантировано устройство МСС с дальнейшей настройкой S-ICD, направленное на исключение двойного считывания сигнала МСС-устройства кардиовертером-дефибриллятором (Cross-talk-тест). В результате выполненных оперативных вмешательств нарушений в работе одновременной двух устройств не отмечено.Заключение. Комбинация подкожного кардиовертера-дефибриллятора и устройств МСС является перспективным направлением для пациентов с ХСН. Продемонстрированное клиническое наблюдение показывает возможность применения S-IСD и устройств МСС с целью профилактики эпизодов внезапной сердечной смерти и улучшению качества жизни.</p></abstract><trans-abstract xml:lang="en"><p>Chronic heart failure (CHF) remains one of the leading causes of morbidity and mortality worldwide. Despite significant advances in pharmacological therapy, a substantial proportion of CHF patients continue to experience disease progression and remain at high risk of sudden cardiac death (SCD). Implantable cardiac devices play a central role in the comprehensive management of CHF, offering both prevention of life-threatening arrhythmias and improvement of the heart’s pump function. Among these, implantable cardioverter-defibrillators and cardiac contractility modulation (CCM) devices are of particular importance, as they target distinct pathophysiological mechanisms of heart failure.This article presents a clinical case of a CHF patient with reduced left ventricular ejection fraction. As the first step, the patient underwent implantation of a subcutaneous implantable cardioverterdefibrillator (S-ICD). The postoperative period was uncomplicated. In the second stage, a CCM device was implanted, followed by S-ICD reprogramming to prevent oversensing of the CCM signal by the defibrillator (cross-talk testing). No interference or malfunction was observed between the two simultaneously functioning devices following the interventions.Conclusion: The combination of a subcutaneous cardioverter-defibrillator and a CCM device represents a promising therapeutic strategy for patients with CHF. This clinical case demonstrates the feasibility of concurrent use of S-ICD and CCM devices for the prevention of sudden cardiac death episodes and improvement of quality of life.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>хроническая сердечная недостаточность</kwd><kwd>подкожная система кардиовертерадефибриллятора</kwd><kwd>профилактика внезапной сердечной смерти</kwd><kwd>модуляция сердечной сократимости</kwd></kwd-group><kwd-group xml:lang="en"><kwd>chronic heart failure</kwd><kwd>subcutaneous implantable cardioverter-defibrillator</kwd><kwd>sudden cardiac death prevention</kwd><kwd>cardiac contractility modulation</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">McDonagh T.A., Metra M., Adamo M., et al. 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DOI: https://doi.org/10.35336/VA-1365</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
