Predictive value of the PRAETORIAN score for defibrillation test success in patients with subcutaneous ICD: A subanalysis of the PRAETORIAN-DFT trial.
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Knops Reinoud E, El-Chami Mikhael F, Marquie Christelle, Nordbeck Peter, Quast Anne-Floor B E, Tilz Roland R, Brouwer Tom F, Lambiase Pier D, Cassidy Christopher J, Boersma Lucas V A, Burke Martin C, Pepplinkhuizen Shari, de Veld Jolien A, de Weger Anouk, Bracke Frank A L E, Manyam Harish, Probst Vincent, Betts Timothy R, Bijsterveld Nick R, Defaye Pascal, Demming Thomas, Elders Jan, Field Duncan C, Ghani Abdul, Golovchiner Gregory, de Jong Jonas S S G, Lewis Nigel, Marijon Eloi, Martin Claire A, Miller Marc A, Shaik Naushad A, van der Stuijt Willeke, Kuschyk Jürgen, Olde Nordkamp Louise R A, Arya Anita, Borger van der Burg Alida E, Boveda Serge, van Doorn Dirk J, Glikson Michael, Kaiser Lukas, Maass Alexander H, van Woerkens Léon J P M, Zaidi Amir, Wilde Arthur A M, Smeding Lonneke
Аннотация
OBJECTIVE: This prespecified subanalysis assessed the predictive value of the PRAETORIAN score for defibrillation success in induced ventricular arrhythmias.
METHODS: This multicenter investigator-initiated trial randomized 965 patients between DFT and PRAETORIAN score calculation after de novo S-ICD implantation. Successful DFT was defined as conversion of induced ventricular arrhythmia in <5 seconds from shock delivery within 2 attempts. Bidirectional chest radiographs were obtained after implantation. The predictive value of the PRAETORIAN score for DFT success was calculated for patients in the DFT arm.
RESULTS: In total, 482 patients were randomized to undergo DFT. Of these patients, 457 (95%) underwent DFT according to protocol, of whom 445 (97%) had successful DFT and 12 (3%) had failed DFT. A PRAETORIAN score of ≥90 had a positive predictive value of 25% for failed DFT, and a PRAETORIAN score of <90 had a negative predictive value of 99% for successful DFT. A PRAETORIAN score of ≥90 was the strongest independent predictor for failed DFT (odds ratio 33.77; confidence interval 6.13-279.95; P < .001).
CONCLUSION: A PRAETORIAN score of <90 serves as a reliable indicator for DFT success in patients with S-ICD, and a PRAETORIAN score of ≥90 is a strong predictor for DFT failure.