Arrhythmias & electrophysiology
Integration of PRAETORIAN Score, defibrillation testing and follow-up outcomes for the assessment of conversion failure in patients with subcutaneous implantable cardioverter defibrillator: Results from the iSUSI registry
- registry
- international
- real-world
+2 more
- international
- real-world
Authors' conclusion
PRAETORIAN score, BMI, and impedance are independent predictors of defibrillation failure. Their combined use may improve risk stratification and may help guide clinical decision-making, especially when DFT is omitted.
Study context
- Population
- Patients with subcutaneous implantable cardioverter defibrillator (S-ICD) with available imaging and complete follow-uppatients analyzed, 748 underwent defibrillation testing (DFT)
- Participants
- 1,063 patients
- Exposure
- PRAETORIAN score and individual components; multivariable model combining PRAETORIAN score, body mass index (BMI), and impedance vs PRAETORIAN score
- Outcome
- Composite of:
- DFT failure
- Ineffective appropriate shocks during follow-up
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
Independent predictors of conversion failure
| Comparison | odds ratio (CI) | P value | |
|---|---|---|---|
| anterior generator position at PRAETORIAN score step 2 | 2.3 (1.2–4.2) | P = 0.006 | |
| 0.20.5125Odds ratio (log scale) |
| Outcome | AUC | P value |
|---|---|---|
| Model performance (AUC) | 0.78 vs 0.71 | P = 0.0078 |
- Model performance (AUC) — Overall PRAETORIAN score AUC
- 0.71
- Model performance (AUC) — step 1-3 AUCs
- 0.68-0.70
- Model performance (AUC) — Overall vs individual steps
- P > .05 for all comparisons
DFT failure and ineffective shocks
- DFT failure among 748 patients who underwent DFT
- 64 (8.6%)
- Ineffective shocks during follow-up
- 17
Independent predictors of conversion failure
- PRAETORIAN score step 1, high body mass index (BMI) and post-shock impedance independently predicted conversion failure
Original publication
Integration of PRAETORIAN Score, defibrillation testing and follow-up outcomes for the assessment of conversion failure in patients with subcutaneous implantable cardioverter defibrillator: Results from the iSUSI registry. Heart Rhythm. Published 26 June 2026. doi:10.1016/j.hrthm.2026.06.024
Summarised from the published abstract; every number is checked against it