“…Patients with incessant ventricular tachycardia (VT), sustained VT despite treatment with antiarrhythmic drugs, or shocks from implantable defibrillators are candidates for catheter ablation (CA). 1 , 2 , 3 Although ablation can be efficacious, mortality is higher in patients with structural heart disease owing to hemodynamic instability from anesthesia and arrhythmia induction. 1 , 3 , 4 The PAINESD risk score helps to identify patients at risk of acute hemodynamic decompensation, permitting selection of those likely to benefit from intraprocedural mechanical circulatory support (MCS).…”