HATCH score for progression from paroxysmal to persistent AF

HATCH score for progression from paroxysmal to persistent AF

HATCH score was developed for prediction of progression from paroxysmal to persistent atrial fibrillation (AF) checks the following: heart failure, age, previous transient ischemic attack or stroke, chronic obstructive pulmonary disease, and hypertension [1]. For the analysis, the authors included 1,219 patients with paroxysmal AF who participated in Euro Heart Survey on AF. Those who had progression of AF after one year of follow up were noted.

The components and weightage given in HATCH score were as follows:

Hypertension: 1

Age 75 years or more: 1

Transient ischemic attack or stroke: 2

Chronic obstructive pulmonary disease: 1

Heart failure: 2

In their study 15% had progression of AF. It was noted that 50% of those with a score more than 5 progressed to persistent AF while only 6% of those with score of zero progressed. Those with progression of AF had more hospitalizations. They also had more major cardiovascular events.

HATCH score was used by Suenari K et al to predict new onset atrial fibrillation using Taiwan National Health Insurance Research Database [2]. Over a two year period spanning from January 1, 2000 to December 31, 2001, they enrolled 670,804 patients older than 20 years who had no history of cardiac arrhythmias. Huge majority of patients had HATCH score of 0. 9174 patients (1.4%) had new onset atrial fibrillation during a mean follow up period of 9 years. The occurrence of new onset atrial fibrillation was 0.8 per 1000 patient-years at HATCH score 0 while it was 57.3 per 1000 patient-years with a HATCH score of 7.

Chen K et al [3] used the HATCH score to predict the occurrence of new onset AF after catheter ablation of typical atrial flutter. Of the 216 patients in their study 39% experienced at least one episode of AF over a follow up period of 29.1 ± 18.3 months. Using a cutoff score of 2, the group could be stratified into high risk group with 69% occurrence of AF vs a lower risk group with 27% occurrence of AF (P < 0.001).

References

1. de Vos CB, Pisters R, Nieuwlaat R, Prins MH, Tieleman RG, Coelen RJ, van den Heijkant AC, Allessie MA, Crijns HJ. Progression from paroxysmal to persistent atrial fibrillation clinical correlates and prognosis. J Am Coll Cardiol. 2010 Feb 23;55(8):725-31.
2. Suenari K, Chao TF, Liu CJ, Kihara Y, Chen TJ, Chen SA. Usefulness of HATCH score in the prediction of new-onset atrial fibrillation for Asians. Medicine (Baltimore). 2017 Jan;96(1):e5597.
3. Chen K, Bai R, Deng W, Gao C, Zhang J, Wang X, Wang S, Fu H, Zhao Y3, Zhang J, Dong J, Ma C. HATCH score in the prediction of new-onset atrial fibrillation after catheter ablation of typical atrial flutter. Heart Rhythm. 2015 Jul;12(7):1483-9.