CHADSVASC Score is Predictive of Mortality in ICD Recipients

Introduction: CHADSVASC score is used to predict thromboembolic complications in patients with atrial fibrillation. Recently it has been used to predict adverse outcomes in other categories of patients. The purpose of this study was to assess the usefulness of CHADSVASC score for prediction of mortality and appropriate ICD therapies in large cohort of ICD and CRTD recipients enrolled in the national ICD Registry.

Methods: A total of 6405 patients listed in the ICD registry were included in the study. Patients were categorized into 2 groups according to the CHADSVASC score: group one with score ≤2 and group 2 with score >2 (2483 (38.7%) and 3922 (61.3%) respectively). The follow up was 2 years.

Results: Patients in group 2 were older (67.7 vs 59.7 years), more likely to be implanted for primary prevention (81% vs 69%), had more CRT devices implanted (44% vs 26%). They were more likely to have a history of myocardial infarction (76% vs 43%), heart failure (93% vs 58%), and atrial fibrillation (24% vs 16%). They also had lower left ventricular ejection fraction (27.5% vs 32.2%) [p

Of 6405 patients, 2342 patients ( 948 (40.5%) in group one and 1394 (59.5%) in group 2) were available for 2 year follow up. Kaplan Meyer analysis (figure 1) demonstrated that patients in group two had significantly higher mortality (156 (11.2%) vs 63 (6.6%) respectively; p<0.001).

Conclusion: CHADSVASC score is predictive of mortality in patients with implanted cardioverter defibrillator.