This study aimed to derive a new score, the Alcohol Septal Ablation-Sudden Cardiac ARREst (ASA-SCARRE) risk score, that can be easily used to evaluate the risk of sudden cardiac arrest events (sudden cardiac death, resuscitation, or appropriate implantable cardioverter-defibrillator discharge) after alcohol septal ablation (ASA) in patients with hypertrophic obstructive cardiomyopathy. We analyzed 1,834 patients from the Euro-ASA registry (49% men, mean age 57 ± 14 years) who were followed up for 5.0 ± 4.3 years (9,202 patient-years) after ASA. A total of 65 patients (3.5%) experienced sudden cardiac arrest events, translating to 0.72 events per 100 patient-years. The independent predictors of sudden cardiac arrest events were septum thickness before ASA (hazard ratio 1.09 per 1 mm, 95% confidence interval 1.04 to 1.14, p <0.001) and left ventricular outflow tract (LVOT) gradient at the last clinical checkup (hazard ratio 1.01 per 1 mm Hg, 95% confidence interval 1.01 to 1.02, p = 0.002). The following ASA-SCARRE risk scores were derived and independently predicted long-term risk of sudden cardiac arrest events: "0" for both LVOT gradient <30 mmHg and baseline septum thickness <20 mm; "1" for LVOT gradient ≥30 mm Hg or baseline septum thickness ≥20 mm; and "2" for both LVOT gradient ≥30 mm Hg and baseline septum thickness ≥20 mm. The C statistic of the ASA-SCARRE risk score was 0.684 (SE 0.030). In conclusion, the ASA-SCARRE risk score may be a useful and easily available clinical tool to predict risk of sudden cardiac arrest events after ASA in patients with hypertrophic obstructive cardiomyopathy.

Cardiocentre Podlesi Trinec Czech Republic

Comprehensive Heart Failure Center University Clinic Wuerzburg Wuerzburg Germany

Department of Cardiology City Hospital No 2 St Petersburg Russian Federation

Department of Cardiology Herlev and Gentofte Hospital Hellerup Denmark

Department of Cardiology Ruhr University Bochum Bochum Germany

Department of Cardiology St Antonius Hospital Nieuwegein Nieuwegein The Netherlands

Department of Cardiology University Hospital Motol 2nd Medical School Charles University Prague Czech Republic

Department of Demography and Geodemography Faculty of Science Charles University Prague Czech Republic

Department of Endovascular Therapy Sverdlovsk Regional Hospital No 1 and Ural Federal University Yekaterinburg Russian Federation

Institute of Biostatistics and Analyses Faculty of Medicine and Faculty of Science Masaryk University Brno Czech Republic

Institute of Cardiovascular Medicine and Science Liverpool Heart and Chest Hospital Liverpool United Kingdom

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