Clinical Electrophysiology -> SCA Risk Assessment: -> Clinical Risk Assessment Techniques D-PO04 - Poster Session IV (ID 15) Poster

D-PO04-210 - The Painsed Risk Score Predicts Mortality In Patients Undergoing Primary Prevention Implantable Cardioverter-defibrillator Implantation (ID 496)


Background: The PAINESD risk score has been demonstrated to predict mortality following catheter ablation of ventricular tachycardia (VT) in patients (pts) with structural heart disease and heart failure. Whether the PAINESD score can also predict mortality in pts undergoing primary prevention implantable cardioverter-defibrillator (PP-ICD) implantation is unknown.
Objective: We evaluated the performance of the PAINESD risk score to predict all-cause mortality in pts undergoing PP-ICD therapy.
Methods: Data from consecutive pts undergoing PP-ICD implantation at our institution between 2017 and 2019 were reviewed. A modified version of the PAINESD excluding the variable “VT storm” was calculated (Figure). All-cause mortality during follow-up was collected using electronic medical records and social security death index.
Results: A total of 311 pts (age 60±15 years, mean LVEF 23±8%, 41% ischemic cardiomyopathy) were included. The median PAINESD score was 11 (interquartile range 6-17), with 102 (33%) pts classified as low risk (≤8 points), 111 (36%) intermediate risk (9-14 points), and 98 (31%) high risk (≥15 points). After a mean follow-up of 11±9 months, 23 (7%) pts died. Patients who died over follow-up had a significantly higher PAINESD score compared to the rest of the population (17±6 vs. 11±7, P<0.001). Cumulative mortality rates over follow-up were 2%, 4% and 17% in pts with low-, intermediate-, and high-risk PAINESD scores respectively (P<0.001 for comparison).
Conclusion: The PAINESD score strongly predicts mortality following PP-ICD implantation and could potentially better identify patients who would benefit most from ICD implantation.