ECG Risk-score Calculator

The ECG Risk-score was developed to assess risk-status for sudden cardiac arrhythmia death (SCD) in patients with hypertrophic cardiomyopathy (HCM) using the resting ECG, and it has been validated in both adult and childhood HCM. Patients with RASopathy associated HCM are not excluded. This is a calculator that facilitates the calculation of the ECG Risk-score.

Exclusion criteria:

The calculator is not validated in patients with post-operative complete left bundle branch block, and it cannot be used on pacing ECGs.

Using this calculator:

For more information about each question hover over or tap the information icon.( [Info icon] )

All numbers should be input using a period or full stop (.) as decimal separator. Writing numbers with a comma (,) will not work. For example '12.3' is correct and '12,3' is not correct.

[Info icon] Mean QRS axis will be displayed in most modern ECG-machines, if not calculate it manually. Both right axis deviation and left axis deviation for age will produce a risk point
[Info icon] A T-wave is considered pathological if it is negative with at least 1 mm in a lead where the T-wave should normally be upright at the age of the patient. Even biphasic T-wave negativity reaching -1 mm gives a point score. Limb leads are I,II,III, aVL, aVF,aVR, and precordial leads are V1-V6 (and V4R if used)
[Info icon] ST-segment depression in any lead of at least -2 mm at its lowest point qualifies for a risk point
[Info icon] S-wave (or QS-wave) has larger amplitude than R-wave in lead V4
[Info icon] The limb- lead amplitude sum is calculated as the sum of total of amplitudes measured from top to bottom of each QRS-complex, thus from top of the R-wave to lowest part of Q or S-wave depending on which is lowest. All limb lead amplitudes (I, II, III, aVL, aVF, aVR) are added together. Can be measured with a ruler from a paper printout (check that mm-scale is correct on print-out, and correct accordingly if scale reduced). Alternatively, from digital ECG-machines voltages are obtainable as output of tables of amplitudes. Amplitudes are added up without including minus signs, since total size of whole QRS-complex in each lead is needed. The sum in mm is converted to mV according to the magnification scale on the ECG recording (often 10mm=1mV, but check amplitude tests)
[Info icon] Use QRS duration displayed in ECG report on digital ECGs, or measure manually from trace correcting for paper speed, and express duration in milliseconds.
[Info icon] 12-lead amplitude sum, is calculated by adding total amplitudes of the QRS-complexes in the six precordial leads (usually V1, V2, V3, V4, V5, V6; but in very young children V3 can be substituted by V4R if V3 not available) by the same method as in limb-leads, and then adding the resulting voltage sum to that of the six limb leads. Can be measured with a ruler from a paper trace or by adding amplitudes (without minus sign) from voltage tables in a digital ECG-machine.
[Info icon] 12-lead amplitude.product = 12-lead amplitude sum * (QRS duration / 1000) is displayed by the calculator in the sort mV.sec. Note that the output will use period or full stop (.) as decimal seperator.
[Info icon] Corrected QT: use value displayed in ECG report, or calculate manually using Bazett's formula: = QT-duration (from beginning of Q to end of T in seconds) / Square Root of previous R-R interval (in seconds)

ECG Score: -

The following fields were not provided and are therefore not included in the calculation:

The following fields' values are substantially outside expected range. Please check that you are using correct units and that there are no typing errors.:

The following fields are improperly input. Please check that you input a correctly formatted number separating decimals with period or full stop (.) and not a comma (,):

The following fields has an unexpected error:



Data usage:

Data that has been input into this calculator exists on your computer/mobile only. No data from the calculator is transferred to any other systems in any way.

Interpretation:

The enclosed publications indicate that patients with an ECG risk-score of 0-2 have low risk, patients with a risk score of 6 or above have an elevated risk, and patients with a score of 3-5 have an intermediate risk status that may deteriorate during follow-up.

Related publications:
Acknowledgements:

The work of creating a web-based on-line calculator was sponsored by a grant from Childrens Heart Center, Queen Silvia Childrens Hospital, Sahlgrenska University Hospitals and Region West Götaland ALF-agreement (Regionbidrag), and the Swedish Heart and Lung Foundation grant 20080510.

Full reference list:
Click here for a fuller reference list