Pacing-Induced Cardiomyopathy (PICM) Score Calculator

Pacing-Induced Cardiomyopathy (PICM) Score: Explanation and Clinical Context The PICM Score estimates the risk of developing pacing-induced cardiomyopathy in patients with chronic right ventricular pacing. This condition is characterized by left ventricular systolic dysfunction caused by ventricular dyssynchrony induced by long-term RV pacing. The score incorporates the percentage of RV pacing, baseline left ventricular ejection fraction (LVEF), history of myocardial infarction, and female sex.

Higher RV pacing percentages and lower baseline LVEF increase risk, while female sex and prior MI also contribute to higher risk. Risk stratification based on the score allows clinicians to identify patients who may benefit from closer monitoring, early echocardiographic follow-up, or consideration of alternative pacing strategies such as biventricular pacing or His-bundle pacing.