To assess the risk of stroke in patients with atrial fibrillation, doctors around the world use a scoring system. Being a woman previously gave one point, but this was changed in the latest European guidelines. The scoring system is now called the CHA2DS2-VA score.

Patients are given points for the following additional risk factors:

Heart failure – 1 point
High blood pressure – 1 point
Age ≥75 years – 2 points
Diabetes – 1 point
Stroke – 2 points
Coronary artery disease or other vascular disease – 1 point
Age 65-74 years – 1 point
The sum of the points determines whether the doctor will advise the patient to use blood thinning treatment.

High risk: Patients with ≥2 points are at high risk of stroke and should use blood thinning treatment.

Moderate risk: In patients with a score of 1, the benefit of blood thinners is more uncertain, and for this reason the decision is left to the doctor and patient together, taking into account the patient’s preferences.

Low risk: Patients with a score of 0 have a low risk of stroke and usually do not need blood thinners. However, it may be necessary in certain situations, for example before and after electroconvulsive therapy or ablation.

We have updated the scoring tool in the ECG247 app and portal to now display the CHA2DS2-VA score.