Pacifico et al developed a model for predicting the risk of death in a patient with an implantable cardioverter-defibrillator (ICD). The authors are from the Texas Arrhythmia Institute and Baylor College of Medicine in Houston, Texas.
Parameter:
(1) left ventricular ejection fraction (LVEF), in percent
(2) discharge shocks for ventricular tachycardia (VT) and/or fibrillation (VF)
Appropriate Discharge Shock
Type of Shock
none at all
no shock
single appropriate shock for a venticular tachyarrhythmia
single shock
rapid sequence of 2 or more appropriate shocks during at least 1 episode of a tachyarrhythmia
multiple shock
where:
• A discharge shock was appropriate if it was triggered by VT or VF
• A person was classified as having multiple shocks if there were any episode during which multiple shocks were given.
• A discharge with multiple shocks is distinct from an electrical storm (see previous section).
Type of Shock
LVEF
Hazard Ratio
Percent Mortality
no
>= 35%
1
2%
no
< 35%
7
12%
single
>= 35%
5
13%
single
< 35%
6
19%
multiple
>= 35%
6
21%
multiple
< 35%
16
50%
Alternatively this can be modified to the following:
Parameter
Finding
Points
type of shock
none
0
single
1
any multiple
2
LVEF
>= 35%
0
< 35%
1
total score =
= SUM(points for both parameter)
Interpretation:
• minimum score: 0
• maximum score: 3
Total Score
Percent Mortality
0
2%
1
12-13%
2
19-21%
3
50%
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