Related Experiment Video
Updated: Mar 11, 2026
A Model of Long-Term Ventricular Fibrillation in Isolated Rat Hearts
Published on: February 17, 2023
CHA2 DS2 VASc score predicts unsuccessful electrical cardioversion in patients with persistent atrial fibrillation
Elzbieta Mlodawska1, Anna Tomaszuk-Kazberuk1, Paulina Lopatowska1
1Department of Cardiology, Medical University of Bialystok, Bialystok, Poland.
Insights
The CHA2DS2VASc score, commonly used for thrombotic risk, can predict the success of electrical cardioversion for atrial fibrillation (AF). Higher scores indicate a greater likelihood of unsuccessful cardioversion, offering a simple predictive tool.
Area of Science:
- Cardiology
- Clinical Medicine
- Arrhythmology
Background:
- Atrial fibrillation (AF) is a prevalent arrhythmia affecting 2% of the population, significantly impacting morbidity and quality of life.
- The CHA2DS2VASc score is a standard metric for assessing thrombotic risk in AF patients.
- Previous research has not explored the CHA2DS2VASc score's utility in predicting electrical cardioversion outcomes.
Purpose of the Study:
- To evaluate the predictive value of the CHA2DS2VASc score for unsuccessful electrical cardioversion in patients with persistent AF.
- To determine if the CHA2DS2VASc score can serve as a reliable indicator of cardioversion success.
Main Methods:
- A retrospective analysis of 258 consecutive patients undergoing electrical cardioversion for persistent AF between January 2012 and April 2016.
- Calculation of CHA2DS2VASc and HAS-BLED scores for all included patients.
- Statistical analysis to identify factors associated with unsuccessful cardioversion, including the CHA2DS2VASc score.
Main Results:
- Electrical cardioversion was unsuccessful in 12% of the 258 patients studied.
- Factors significantly associated with unsuccessful cardioversion included older age, history of ischemic stroke, male gender, and a higher CHA2DS2VASc score (P=0.002).
- Patients with unsuccessful cardioversion had a significantly higher mean CHA2DS2VASc score (3.5) compared to those with successful cardioversion (2.4, P=0.001). A 1-point increase in CHA2DS2VASc score correlated with a 39% increase in the odds of unsuccessful cardioversion (OR 1.39).
Conclusions:
- The CHA2DS2VASc score demonstrates potential as a simple, accessible, and effective tool for predicting the likelihood of unsuccessful electrical cardioversion in AF patients.
- Routine assessment of the CHA2DS2VASc score may aid clinicians in managing patient expectations and planning cardioversion strategies.
Background:
Atrial fibrillation (AF) is the most common arrhythmia occurring in 2% of the population. It is known that AF increases morbidity and limits quality of life. The CHA2 DS2 VASc score (congestive heart failure/left ventricular dysfunction, hypertension, age ≥75 (doubled), diabetes, stroke (doubled), vascular disease, age 65-74 and sex category (female)) is widely used to assess thrombotic complications. The CHA2 DS2 VASc score was not used until now in predicting the effectiveness of electrical cardioversion.
Aim:
To assess the value of CHA2 DS2 VASc score in predicting unsuccessful electrical cardioversion.
Methods:
We analysed 258 consecutive patients with persistent AF who underwent electrical cardioversion between January 2012 and April 2016 in a Cardiology University Centre in Poland.
Results:
Out of 3500 hospitalised patients with AF, 258 (mean age 64 ± 11 years, 64% men) underwent electrical cardioversion. The CHA2 DS2 VASc score in analysed population (258 patients) was 2.5 ± 1.7 (range 0-8), and the HAS-BLED (hypertension, abnormal liver or renal function, stroke, bleeding, labile international normalised ratio, elderly, drugs or alcohol) was 1 ± 0.9 (range 0-4). Electrical cardioversion was unsuccessful in 12%. Factors associated with unsuccessful cardioversion were age (P = 0.0005), history of ischaemic stroke (P = 0.04), male gender (P = 0.01) and CHA2 DS2 VASc score (P = 0.002). The CHA2 DS2 VASc score in patients who had unsuccessful cardioversion was higher compared to patients who had successful cardioversion - 3.5 versus 2.4 (P = 0.001). In the logistic regression model, if the CHA2 DS2 VASc score increases by 1, the odds of unsuccessful cardioversion increase by 39% (odds ratio (OR) 1.39; confidence interval (CI): 1.12-1.71; P = 0.002). The odds of unsuccessful cardioversion are three times higher in patients with a CHA2 DS2 VASc score ≥ 2 than in patients with a CHA2 DS2 VASc score of 0 or 1 (OR 3.06; CI: 1.03-9.09; P = 0.044).
Conclusion:
The CHA2 DS2 VASc score routinely used in thromboembolic risk assessment may be a simple, easy and reliable scoring system that can be used to predict unsuccessful electrical cardioversion.
More Related Videos
06:57Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
Published on: January 31, 2019
10:46Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology
Published on: May 26, 2015