HATCH Score (Atrial Fibrillation Progression): Explanation and Clinical Context The HATCH Score is a validated risk assessment tool designed to predict the likelihood of progression from paroxysmal atrial fibrillation (AF) to persistent or permanent AF. Developed from a cohort study by De Vos et al., the score incorporates five key clinical predictors: heart failure, age >75 years, history of transient ischemic attack (TIA) or stroke, chronic obstructive pulmonary disease (COPD), and hypertension.
Scoring:
• Heart Failure: 2 points
• Age >75 years: 1 point
• TIA/Stroke: 1 point
• COPD: 1 point
• Hypertension: 1 point
Total scores range from 0 to 6 points.
Interpretation:
• 0–1: Low risk of AF progression
• 2–4: Intermediate risk
• >5: High risk of progression
HATCH Score helps clinicians identify patients with paroxysmal AF who may benefit from early rhythm control interventions, closer monitoring, or consideration for catheter ablation. It is particularly valuable for individualized treatment planning in elderly patients and those with structural heart disease.
Reference:
De Vos CB, et al. “Progression from paroxysmal to persistent atrial fibrillation: clinical correlates and prognosis.” J Am Coll Cardiol. 2010;55:725–731.
Nieuwlaat R, et al. “Atrial fibrillation management: a contemporary review.” Lancet. 2016;388:1130–1143.
Kirchhof P, et al. “2016 ESC Guidelines for the management of atrial fibrillation.” Eur Heart J. 2016;37:2893–2962.