ATRIA Score/Chad Score

[Slattery]

The ATRIA gives me a different score than the Chad score. The ATRIA score seems. More sensible than the Chad score. What do you think?

[CaroleF]

I'd never heard of the ATRIA score before so have just googled it and found this:

neurologyadvisor.com/stroke...

It seems to me that which scoring system is 'more sensible' is dependent on whether you are at high risk of stroke or not. However, I am no statistician and am not confident that I properly understand the article (above). Maybe others here can comment more effectively than me?

[Buffafly]

I filled in the ATRIA form and got 4 points, low risk of stroke. Low risk is not NO risk! If you are happy to take a small gamble that is your choice but considering that if I lose I could end up what my grandma described as a cabbage I prefer not to gamble.

mdcalc.com/atria-stroke-ris...

[Thomps95]

If it were me - I'd probably take a conservative approach - if *either* system recommended anticoagulation, I'd consider it seriously. However, if neither recommends it, then I'd avoid taking tablets you don't need. It isn't just that your risk is low - the problem with those who are "truly low risk" is that the incidence of stroke is the same in those who take anticoagulation and those who don't (according to the largest and most recent European study) so there is no benefit of anticoagulation. The other point is that there are dozens of lifestyle things you can do to reduce your risk of stroke (regular exercise and stress reduction being obvious ones). Take these lifestyle factors very seriously.

[Jans5]

I would have liked to be told in terms of numbers what 5 times more likely to suffer a stroke actually means when I was diagnosed. I have later found patient aids that can be used to help patients decide about their treatment and also the Qrisk which both set out your risk in terms of numbers.

[BobD Volunteer]

I think the point is that this new idea identifies people at LOW risk and as has been mentioned not NO risk. As has already been mentioned elsewhere it is not necessarily the AF that causes the stroke risk but the company it keeps. You are perfectly free to choose whatever you wish but do remember low risk is not no risk. There have been plenty of people here who have had a low CHADVASC score and gone on to have TIA or stroke.

[Jans5]

The problem I had was that it states that afib gives you 5 times the risk which is very scary. You think your going to imminently have a stroke. If I'd been told that in fact a Chad score of 1 or 2 (if you're a women) is 0.6 ie 6 in 1000 compared to people without afib who according to the stroke association have a 0.11 to 0.15 risk of stroke. This is without anticoagulants. I've not reached this yet so my risk is lower and I most likely will take them when I reach 65. No one in the world or at any age is at no risk of a stroke but I like to think on the positives that at the moment I'm at less than 99.4% risk of not having one.

[Jomama]

I just tried this and got a score of 2, and it seems I have a very low risk of stroke, less than or equal to 1%stroke risk and this ADVICE

Patients should be evaluated for bleeding risk before initiating anticoagulation; risk of bleeding can be estimated using the HAS-BLED Score for Major Bleeding Risk or several other scores.

My EP says I can go off of anti-coagulants after two months post ablation. I was very nervous about that but this makes me feel better.

[Jumper]

The CHA2DS2-VASc score calculates stroke risk for patients with atrial fibrillation

My EP has informed me that my CHA2DS2-VASc score is 1 because of my age of 70. However he sees no reason why I should be coagulated even though I am at Low - Moderate Risk.

He has taken the view that I don't need coagulating for two reasons.

1. After ablation some 7 years ago and a routine follow up at 70 on 48hr halter monitor showed 'events' limited to less than 1% of total beats.

2. Ultra sound scans shows my heart structure to be sound. ie no left atrial enlargement.

What doesn't come across in this forum is the incidence and length of time that sufferers are in AF. Is it Paroxysmal AF or persistent AF or permanent AF that determines whether one should be anti-coagulated.

If Paroxysmal is it a day of AF that says one should be coagulated and if persistent one week of AF should be coagulated.

I am still classified as an AF sufferer and have been so for 17 years but following PVI 7 years ago now limited to daily/events of ectopics with occasional 10 second bursts of AF. So am I really no risk as am only low level PAF

The CHA2DS2-VASc must only be a guide as someone in permanent AF is at the same level of risk as one who gets irregular bouts of PAF that seems to me to a bit non-sensical/illogical.

So does any one have an opinion/experience as to how long one should be in AF to be classified as at sufficient risk to be anti coagulated.

[dedeottie]

If I count my 3 TIAs as a stroke, my score is 9 and high risk. If I dont count them my score is 1 and very low risk. That is why I was not put on anticoagulants and then hey presto I had my TIAs. Not meaning to scare monger but surely that shows that these charts are flawed. I dont think I am so unusual as There are other people on the forum who had similar scenarios. However I will say that I had them during a very stressful period in my life. My mum and dad were dying and lived 100 miles away. I didnt have the time to look after myself. I was on no rate or rhythm control ( useless G.P. ) and was constantly in and out of A.F. so Im sure non of that helped. X

Very interesting discussion though.