Arrhythmias & electrophysiology

A novel electrocardiographic risk score for sudden cardiac arrest in patients with atrial fibrillation: The sudden cardiac arrest in atrial fibrillation electrical risk score (SCAAF-ERS)

Heart RhythmPublished case-control study

Authors' conclusion

SCA risk was predicted successfully from AF ECGs, with a novel risk score displaying 13- to 23-fold increased odds. Further validation of the SCAAF-ERS in larger, diverse populations is warranted.

Study context

Population
Subjects aged ≥18 years with medical records and pre-arrest electrocardiogram (ECGs) showing atrial fibrillation (AF) (cases with sudden cardiac arrest (SCA)); controls with AF ECGs without SCA history; Oregon, USA (2002–2020) and California (2015–2023)discovery group and validation group, cases and controls · discovery group cases 447 · discovery group controls 138 · validation group cases 315 · validation group controls 138
Comparison
SCAAF-ERS for predicting SCA in individuals with AF, cases vs controls
Outcome
SCA risk per point increase in SCAAF-ERS (discovery group)
Methodological detailscommunity-based, validation in a California study
  • Community-based
  • Validation in a California study

Main finding

As reported in the abstract

  • Per point increase: 1.5 times (95% CI 1.2–1.9)

Observational data: associations, not effects.

Further findings

SCAAF-ERS ≥4 (discovery group)

OR (95% CI)
SCAAF-ERS ≥4SCAAF-ERS ≥4 (16%)12.9 (3.4–48.1)

SCAAF-ERS ≥3 (validation group)

OR (95% CI)
SCAAF-ERS ≥3SCAAF-ERS ≥3 (27%)22.9 (9.0–58.3)
OutcomeEstimate
SCA risk per point increase in SCAAF-ERS (validation group)(95% CI 1.9–3.1)

SCA risk per point increase in SCAAF-ERS (validation group)

SCA risk doubled per point increase

Discovery group characteristics and SCAAF-ERS components

Mean age
74.9 years
Male
73.5%
1 point for each: prolonged QTc, QRS-T angle >100°, Tpeak-Tend >94 ms, left ventricular hypertrophy, delayed QRS transition

Validation group characteristics

Mean age
77.7 years
Male
64.5%

Original publication

A novel electrocardiographic risk score for sudden cardiac arrest in patients with atrial fibrillation: The SCAAF-ERS. Heart Rhythm. Published 14 February 2026. doi:10.1016/j.hrthm.2026.02.009

Composed by AI from the published abstract and checked against it. How Briefs are made →

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