Predictive score for supraventricular arrhythmia after patent foramen ovale percutaneous closure - 29/08/26

Doi : 10.1016/j.acvd.2026.07.001

Louis Giovachini ^a, Marie Hauguel-Moreau ^b, Claire Dauphin ^c, Mikael Laredo ^a, Nicolas Meneveau ^d, Meyer Elbaz ^e, Patrick Ohlmann ^f, Jeremie Abtan ^g, Jules Mesnier ^g, Florent Huang ^a, Vincent Auffret ^h, Paul Barsoum ⁱ, Jean-Michel Clerc ^j, Jean-Noël Andarelli ^k, Farzin Beygui ^l, Antoine Da Costa ^m, Paul Gabrion ⁿ, Michel Zeitouni ^a, Thomas Rolland ^a, Nadjib Hammoudi ^a, Johanne Silvain ^a, Eric Vicaut ^o, Gilles Montalescot ^a,⁎ , Paul Guedeney ^a
on
behalf of the AFLOAT Investigators ^¹
AFLOAT Investigators: Marie Hauguel-Moreau, Paul Guedeney, Claire Dauphin, Vincent Auffret, Jean-Michel Clerc, Eloi Marijon, Meyer Elbaz, Philippe Aldebert, Farzin Beygui, Wissam Abi Khalil, Antoine Da Costa, Jean-Christophe Macia, Simon Elhadad, Guillaume Cayla, Xavier Iriart, Mikael Laredo, Thomas Rolland, Yassine Temmar, Maria Elisabeta Gheorghiu, Delphine Brugier, Johanne Silvain, Nadjib Hammoudi, Guillaume Duthoit, Abdourahmane Diallo, Eric Vicaut, Gilles Montalescot.

the
AIR FORCE Investigators ^²
AIR FORCE Investigators: Niki Procopi, Marie Dupuy, Anthony Elhadad, Perrine Devos, Thomas Wallet, Camille Granger, Johanne Silvain, Eric Vicaut, Claire Dauphin, Nicolas Meneveau, Matthieu Besutti, Jeremie Abtan, Jules Mesnier, Arthur Souquet, Patrick Ohlmann, Gora Ndiaye, Marion Kibler, Vincent Roule, Farzin Beygui, Paul Gabrion, Alexis Hermida, Laurent Leborgne, Florent Huang, Hakim Benamer, Matthieu Perier, Vincent Elbaz, Benjamain Haber, Vincent Auffrey, Paul Barsoum, Nadjib Lehbib, Marie Hauguel-Moreau, Gabriel Chevrot, Guillaume Cayla, Benoit Gerardin, Jean Noel Andarelli, Gregoire Albenque, Julien Rosencher, Sabrina Uhry, Camille Siegel, Emmanuel Boiffard, Laurent Payot, Farouk Abcha, Emmanuel Gall, Alexandre Lafont, Laszlo Levai, Anthony Matta, Philippe Garot, Gilles Rioufol.

the
ACTION Study Group

^a Sorbonne Université, Paris, France, ACTION Study Group, INSERM UMRS 1166, Institut de Cardiologie, Hôpital Pitié-Salpêtrière (AP-HP), 75013 Paris, France

^b Université de Versailles-Saint Quentin, INSERM U1018, CESP, ACTION Study Group, Department of Cardiology, Ambroise Paré Hospital (AP-HP), 92100 Boulogne, France

^c Department of Cardiology and Cardiovascular Diseases, Clermont-Ferrand University Hospital, 63100 Clermont-Ferrand, France

^d Department of Cardiology, University Hospital Besançon, SINERGIES, University of Franche-Comté, F-CRIN, INNOVTE network, 25000 Besançon, France

^e Department of Cardiology, Institute CARDIOMET, CHU-Toulouse, 31200 Toulouse, France

^f Department of Cardiology, Strasbourg University Hospital, 67200 Strasbourg, France

^g Cardiology Department, Bichat-Claude-Bernard Hospital, 75018 Paris, France

^h University Hospital Pontchaillou, Cardiology and Vascular Disease Department, CIC-IT 804, Rennes 1 University, Signal and Image Processing Laboratory (LTSI), INSERM U1099, 35000, Rennes, France

ⁱ Service de cardiologie, Hopital Robert Ballanger, 93600 Aulnay-Sous-Bois, France

^j Cardiology Department, Centre Hospitalier Universitaire de Tours, 37100 Tours, France

^k Marie Lannelongue Hospital, Groupe Hospitalier Paris Saint Joseph, Faculté de Médecine Paris-Saclay, Université Paris-Saclay, 92350 Le Plessis Robinson, France

^l CHU de la Côte de Nacre, Département de Cardiologie & INSERM UMRS 1237, 14033 Caen, France

^m Service de cardiologie, hôpital Nord, université Jean-Monnet, CHU de Saint-Étienne, 42100 Saint-Étienne, France

ⁿ Department of Cardiology, Amiens University Hospital, 80054 Amiens, France

^o Unité de Recherche Clinique, ACTION Group, Hôpital Fernand Widal (AP-HP), SAMM (Statistique, Analyse et Modélisation Multidisciplinaire) EA 4543, Université Paris 1 Panthéon Sorbonne, 75010 Paris, France

^⁎ Corresponding author. ACTION group, Institut de Cardiologie, Pitié-Salpêtrière hospital, 47-83, boulevard de l’hôpital, 75013 Paris, France. ACTION group, Institut de Cardiologie, Pitié-Salpêtrière hospital 47-83, boulevard de l’hôpital Paris 75013 France

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Saturday 29 August 2026

Graphical abstract

Le texte complet de cet article est disponible en PDF.

Highlights

•	SVA occurs in 31.5% of patients after PFO closure with ILR monitoring.
•	A six-variable score predicts SVA risk after percutaneous PFO closure.
•	The score uses routine clinical and echographic parameters.
•	Internal validation showed good discrimination, with an AUC of 0.72.
•	External validation confirmed higher SVA rates in high-score patients.

Le texte complet de cet article est disponible en PDF.

Abstract

Background

Supraventricular arrhythmia (SVA) is the most frequent complication after patent foramen ovale (PFO) percutaneous closure.

Aim

To develop and validate a predictive score for SVA after PFO closure.

Methods

Patients with PFO closure and undergoing implantable loop recorder (ILR) monitoring were recruited in 15 French centres. The primary outcome was any SVA lasting ≥30 s within 3 months after the procedure. The score was derived from multivariable logistic regression from a training set of patients and was tested in an independent internal validation set. The score was then externally validated in a cohort of patients without ILR monitoring from the AIR FORCE registry.

Results

Overall, 338 patients undergoing ILR monitoring (270 in the training set; 68 in the internal validation set) and 2215 not undergoing ILR monitoring (external validation set) were included. Determinants of the prognostic score were age, male sex, RoPE score, septum secundum thickness, left atrial volume and device left disc diameter. In the internal validation set, the area under the curve was 0.72 (0.58–0.87). A threshold of 55 (fourth quartile of the training set score) had a specificity of 93.3% and a positive predicted value of 72.7%. In the external validation set, the score demonstrated a similar correlation, with an observed threefold increase in the symptomatic SVA rate between the first and fourth quartiles.

Conclusions

This easily calculable score can be used to identify patients at high risk of developing SVA after PFO closure and may help detect candidates for a specific rhythm-monitoring strategy.

Le texte complet de cet article est disponible en PDF.

Keywords : Supraventricular arrhythmia, Patent foramen ovale closure, Predictive score