Sudden cardiac death risk in hypertrophic cardiomyopathy (HCM Risk-SCD)
Estimates five-year sudden cardiac death risk in hypertrophic cardiomyopathy and supports the ICD decision.
When to use
Adult with hypertrophic cardiomyopathy being assessed for an implantable cardioverter defibrillator.
Pearls and pitfalls
- Maximal wall thickness, left atrium and gradient enter in the original units, millimetres and millimetres of mercury.
- The model uses age at evaluation and the maximal gradient at rest or after provocation.
- The 2023 cardiomyopathy guideline keeps HCM Risk-SCD as the main tool and recognises additional modifiers such as extensive late gadolinium enhancement and reduced ejection fraction.
- The 2014 guideline does not use the model in people under 16 years, elite athletes or people with metabolic or infiltrative disease.
- The score estimates population risk and does not decide alone: the ICD decision is shared with the patient.
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Formula
Prognostic index from wall thickness, left atrium, gradient, family history, NSVT, syncope and age; five-year risk = 1 − 0.998 raised to the exponential of the index.
Evidence
Model derived in 3,675 patients with hypertrophic cardiomyopathy and adopted by the European guidelines, with published external validation.
References
- Authors/Task Force members. 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy. Eur Heart J. 2014;35(39):2733-2787. doi:10.1093/eurheartj/ehu284
- O'Mahony C, Jichi F, Pavlou M, et al. A novel clinical risk prediction model for sudden cardiac death in hypertrophic cardiomyopathy (HCM Risk-SCD). Eur Heart J. 2014;35(30):2010-2020. doi:10.1093/eurheartj/eht439
- Hang F, Fan C. Validation of the HCM Risk-SCD model in a Chinese hypertrophic cardiomyopathy cohort. J Clin Med. 2025;14(20):7355. doi:10.3390/jcm14207355
Frequently asked questions
What is Sudden cardiac death risk in hypertrophic cardiomyopathy (HCM Risk-SCD)?
Estimates five-year sudden cardiac death risk in hypertrophic cardiomyopathy and supports the ICD decision. Adult with hypertrophic cardiomyopathy being assessed for an implantable cardioverter defibrillator.
How is the result calculated?
Prognostic index from wall thickness, left atrium, gradient, family history, NSVT, syncope and age; five-year risk = 1 − 0.998 raised to the exponential of the index.
How should the result be interpreted?
Model derived in 3,675 patients with hypertrophic cardiomyopathy and adopted by the European guidelines, with published external validation.
What are the sources?
Authors/Task Force members. 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy. Eur Heart J. 2014;35(39):2733-2787. O'Mahony C, Jichi F, Pavlou M, et al. A novel clinical risk prediction model for sudden cardiac death in hypertrophic cardiomyopathy (HCM Risk-SCD). Eur Heart J. 2014;35(30):2010-2020. Hang F, Fan C. Validation of the HCM Risk-SCD model in a Chinese hypertrophic cardiomyopathy cohort. J Clin Med. 2025;14(20):7355.