Cardiac Confiscation

Chanting an unholy litany, you reach out with a grasping motion toward your target and cause its heart to leap out of its chest and into your hand. The target must make a Constitution save. A target with 200 or fewer hit points remaining that fails its saving throw is instantly reduced to 0 hit points. The creature is slowed until the beginning of your next turn, at which point it dies. If the affected creature receives a regenerate spell before the beginning of your next turn, the creature gains the normal benefits of that spell and doesn’t immediately die when your next turn begins. If a creature that dies from death clutch is brought back from the dead, it must also be targeted with regenerate on the following round to restore its missing heart or be unable to return to life.

A target with 201 or more hit points that fails its saving throw manages to keep its heart from leaping out of its chest, but it is still slowed(as if by the Slow spell)for 1 minute, has its Constitution reduced by 1d4 each round. They can repeat the saving throw at the end of their turn to end the effect.

Regardless of its current hit points, if the target succeeds at its save, it is still slowed until the beginning of your next turn as it feels its heart wrenching within its chest.