Objective:

To investigate the predictive value of the CHA2DS2-VA score for all-cause and cardiovascular mortality and ventricular arrhythmia specifically in ICD patients with ischemic heart disease and dilated cardiomyopathy.

Key Findings:

• Median CHA2DS2-VA score was 3 overall, 2 in DCM, and 4 in IHD patients.
• 46% of patients died during a median follow-up of 7.5 years.
• Higher CHA2DS2-VA scores correlated with increased all-cause and cardiovascular mortality in both IHD (HR 2.36, 95% CI 1.99–2.80) and DCM (HR 1.98, 95% CI 1.44–2.73).
• Each one-point increase in CHA2DS2-VA increased mortality risk (HR 1.4, 95% CI 1.34–1.47).
• No association was found between CHA2DS2-VA and the occurrence of ventricular arrhythmias.

Interpretation:

The CHA2DS2-VA score is a strong predictor of all-cause and cardiovascular mortality in ICD patients with IHD and DCM, indicating its potential role in clinical decision-making, but it does not predict ventricular arrhythmias.

Limitations:

• The study is limited to a single center, which may affect generalizability to broader populations.
• The analysis did not include patients without ICD therapy, potentially limiting the applicability of findings.

Conclusion:

CHA2DS2-VA is useful for mortality risk stratification in ICD patients but should not be used for arrhythmic risk assessment.