Benefit of CHA2 DS2 -VASc Score in Predicting Implantable Cardioverter Defibrillator Shocks

Abstract

Introduction: Implantable cardioverter defibrillators (ICDs) reduce the risk of sudden death in eligible patients. However, it is thought that there is a relationship between the ICD shocks and increased morbidity and mortality. In this study, we examined the relationship between ICD shocks and the CHA2DS2-VASc scoring, which has gained frequent use in predicting cardiac events recently. Material and Methods: Retrospective baseline characteristics and three-year follow-ups of patients with ICDs with appropriate indication were studied. Patients were divided into two groups: patients who have received ICD shock(s) and patients who have not received any ICD shock. These groups were compared for baseline characteristics and CHA2DS2-VASc scores. Results: CHA2DS2-VASc scores of heart failure (HF) patients in our study population were significantly higher than those who did not receive any shock within three years following the ICD implantation. The rate of appropriate or inappropriate ICD shocks was %16 in the HF patients implanted with ICD for primary prevention while it was %66 in patients implanted with ICD for secondary prevention. The incidence of atrial fibrillation was 68% in 37 patients who received inappropriate shock while it was 7% in those who did not receive inappropriate shock (those who received appropriate shocks or did not receive any shock) (p<0.001). Conclusion: In conclusion, this study demonstrated a relation between the CHA2DS2-VASc score and appropriate and inappropriate ICD shocks. The CHA2DS2-VASc score is a simple tool that may predict ICD shocks.