Arrhythmias & electrophysiologyCase-control study
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)
- case-control study
- community-based
- validation in a California 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
Main finding
As reported in the abstract
SCA risk per point increase in SCAAF-ERS (discovery group)
- per point increase: 1.5 times (95% CI 1.2–1.9)
Observational data: associations, not effects.
Further findings
SCAAF-ERS ≥4 (discovery group)
| Comparison | OR (95% CI) | |
|---|---|---|
| SCAAF-ERS ≥4 · SCAAF-ERS ≥4 (16%) | 12.9 (3.4–48.1) | |
| 0.050.21520Odds ratio (log scale) |
SCAAF-ERS ≥3 (validation group)
| Comparison | OR (95% CI) | |
|---|---|---|
| SCAAF-ERS ≥3 · SCAAF-ERS ≥3 (27%) | 22.9 (9.0–58.3) | |
| 0.050.21520Odds ratio (log scale) |
| Outcome | Estimate |
|---|---|
| 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
Summarised from the published abstract; every number is checked against it