This scoring system was devised to complement the Khairy score for risk stratification in repaired tetralogy of Fallot. The system includes measurement of RVEF and LVEF by cardiac MRI. The composite primary outcome was defined as all-cause mortality or ventricular arrhythmia, defined as aborted cardiac arrest or documented ventricular fibrillation and ventricular tachycardia (lasting ≥30 seconds or recurrent symptomatic).
The authors comment: "diagnostic accuracy (C statistic, 0.75) of the final point-based model may be insufficient to directly identify patients for ICD implantation for primary prevention. Alternatively, the present non-invasive risk model could be used to select high-risk patients for invasive investigations to further assess the need for ICD implantation, although this needs to be determined in future studies."
JP Bokma et al. Value of Cardiovascular Magnetic Resonance Imaging in Noninvasive Risk Stratification in Tetralogy of Fallot.
JAMA Cardiol. 2017;2(6):678-683.
If there is uncertainty in an individual patient, other potential risk factors to consider may include: sustained atrial arrhythmia; fragmented QRS; peak VO2 and VE/VCO2 slope; raised BNP; extensive late enhancement on cardiac MRI.
