A predictive score for supraventricular arrythmia after Patent Foramen Ovale percutaneous Closure

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Abstract Background Supraventricular arrhythmia (SVA) is the most frequent complication after patent foramen ovale (PFO) percutaneous closure. Objectives To develop and validate a predictive score for SVA after PFO closure. Methods Patients with PFO closure and implantable loop recorder (ILR) monitoring were recruited in 15 French centers. Primary outcome was any SVA lasting ≥ 30 seconds within 3 months after procedure. The score was derived from multivariate logistic regression from a training set of patients, and then first tested in an independent internal validation set. Secondly, we performed an external validation in patients without ILR monitoring from centres of the AIR FORCE registry. Results Overall, 338 patients were included (270 in the training set - 68 in the internal validation set). Determinants of the prognostic score were age, sex, RoPE score, septum secundum thickness, left atrial volume and device left disc diameter. In the internal validation set, the Area Under the Curve (AUC) was 0.72 [0.58-0.87]. A threshold of 55 (fourth quartile of the training population score) had a specificity of 93.3% and a positive predicted value of 72.7%. The external validation in 2215 patients with clinical follow-up demonstrated a similar correlation with an observed three-fold increase in symptomatic SVA rate between the first and fourth quartiles. Conclusions A readily calculable score enables the identification of patients at high-risk of developing SVA after PFO closure patients and could help identify candidates for a specific rhythm monitoring strategy.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.