Sudden cardiac death

HCM Risk-SCD

Estimates the five-year risk of sudden cardiac death in adults with hypertrophic cardiomyopathy using the ESC HCM Risk-SCD model.

Intended population

Use in patients aged 16 years or older with hypertrophic cardiomyopathy who are undergoing primary-prevention sudden cardiac death risk assessment. This model is not intended for survivors of cardiac arrest or patients with previous sustained ventricular tachycardia.

Clinical variables

Enter patient data

AgeAge at clinical evaluation.yearsAccepted range: 16–100 yearsMaximum LV wall thicknessMaximum measured LV wall thickness.mmAccepted range: 10–50 mmLeft atrial diameterAnteroposterior left atrial diameter.mmAccepted range: 20–80 mmMaximum LVOT gradientMaximum resting or provoked gradient.mmHgAccepted range: 0–250 mmHg

ESC risk categories

Lower estimated risk

<4% at 5 years

ICD generally not indicated solely by the calculated estimate.

Intermediate risk

4% to <6%

ICD may be considered after individualized assessment.

Higher estimated risk

≥6% at 5 years

Primary-prevention ICD evaluation should be considered.

Important clinical limitations

The result must not be used as the sole basis for an ICD decision. Extensive late gadolinium enhancement, LV systolic dysfunction, apical aneurysm, genotype, competing mortality, comorbidities and patient preferences may alter the final assessment.

Exercise caution in patients with maximum wall thickness of 35 mm or more and in patients previously treated with surgical myectomy or alcohol septal ablation.

References

O'Mahony C, Jichi F, Pavlou M, Monserrat L, Anastasakis A, Rapezzi C, Biagini E, Gimeno JR, Limongelli G, McKenna WJ, Omar RZ, Elliott PM; Hypertrophic Cardiomyopathy Outcomes Investigators. A novel clinical risk prediction model for sudden cardiac death in hypertrophic cardiomyopathy (HCM risk-SCD). Eur Heart J. 2014 Aug 7;35(30):2010-20. doi: 10.1093/eurheartj/eht439. Epub 2013 Oct 14. PMID: 24126876.

Authors/Task Force members; Elliott PM, Anastasakis A, Borger MA, Borggrefe M, Cecchi F, Charron P, Hagege AA, Lafont A, Limongelli G, Mahrholdt H, McKenna WJ, Mogensen J, Nihoyannopoulos P, Nistri S, Pieper PG, Pieske B, Rapezzi C, Rutten FH, Tillmanns C, Watkins H. 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J. 2014 Oct 14;35(39):2733-79. doi: 10.1093/eurheartj/ehu284. Epub 2014 Aug 29. PMID: 25173338.

This calculator provides clinical decision support and does not replace comprehensive evaluation by an experienced cardiomyopathy or electrophysiology specialist.