Crea Pasquale, Vizzari Giampiero, Rubino Claudia, Taverna Giovanni, Oreto Lilia, Mancini Nastasia, Vetta Giampaolo, Ceratti Simona, Certo Giuseppe, Parlavecchio Antonio, Caminiti Rodolfo, Licordari Roberto, Calabrese Vincenzo, La Spina Paolino, Piccione Maurizio Cusmà, Costa Francesco, Dattilo Giuseppe, Carerj Scipione, Di Bella Gianluca, Micari Antonio, Zito Concetta
Department of Clinical and Experimental Medicine-Cardiology Unit.
Department of Clinical and Experimental Medicine- Paediatric Cardiology Unit, University of Messina, Messina, Italy.
J Cardiovasc Med (Hagerstown). 2025 Aug 1;26(8):444-453. doi: 10.2459/JCM.0000000000001759. Epub 2025 Jun 23.
Transcatheter patent foramen ovale (PFO) closure has emerged as the therapeutic gold standard in patients with a PFO-related stroke. New-onset atrial fibrillation appears as an early complication of this procedure. Our study aims to evaluate if the MVP (Morphology-Voltage-P wave duration) ECG risk score calculated before PFO closure might be a valuable predictor of early postprocedural atrial fibrillation occurrence.
We enrolled all consecutive patients (aged 18-65 years) who underwent percutaneous PFO closure between July 2020 and August 2023. The MVP ECG risk score was calculated. Patients were reassessed with clinical and echocardiographic follow-up at 1 month and 6 months later, to assess the efficacy and safety of the procedure as well as atrial fibrillation occurrence. Patients were then divided into two groups according to the occurrence of early atrial fibrillation after PFO closure.
We enrolled 103 patients, 63.1% male (mean age 48.7 ± 10.6 years). At the end of follow-up, atrial fibrillation occurred in five patients (4.9%). When comparing groups with and without atrial fibrillation diagnosis at follow-up, there was a statistically significant difference in MVP ECG risk scores (3.0 versus 1.0; P = 0.001). At receiver operating characteristic analysis, the MVP ECG risk score showed good diagnostic accuracy in predicting the diagnosis of atrial fibrillation at follow-up [AUC: 0.90; 95% confidence interval (CI) 0.81-0.98]. In the multivariate Cox proportional hazard model, the MVP ECG risk score remained the only independent predictor of atrial fibrillation onset (hazard ratio 2.96; 95% CI 1.13-7.71; P = 0.03).
The MVP ECG risk score could be an independent predictor of early atrial fibrillation occurrence in patients undergoing percutaneous PFO closure.
经导管卵圆孔未闭（PFO）封堵术已成为PFO相关卒中患者的治疗金标准。新发房颤是该手术的早期并发症之一。我们的研究旨在评估PFO封堵术前计算的MVP（形态学-电压-P波时限）心电图风险评分是否可能是术后早期房颤发生的有价值预测指标。
我们纳入了2020年7月至2023年8月期间连续接受经皮PFO封堵术的所有患者（年龄18 - 65岁）。计算MVP心电图风险评分。术后1个月和6个月对患者进行临床和超声心动图随访，以评估手术的疗效和安全性以及房颤的发生情况。然后根据PFO封堵术后早期房颤的发生情况将患者分为两组。
我们纳入了103例患者，男性占63.1%（平均年龄48.7±10.6岁）。随访结束时，5例患者（4.9%）发生房颤。比较随访时有房颤诊断和无房颤诊断的两组，MVP心电图风险评分有统计学显著差异（3.0对1.0；P = 0.001）。在受试者工作特征分析中，MVP心电图风险评分在预测随访时房颤诊断方面显示出良好的诊断准确性[AUC：0.90；95%置信区间（CI）0.81 - 0.98]。在多变量Cox比例风险模型中，MVP心电图风险评分仍然是房颤发作的唯一独立预测指标（风险比2.96；95% CI 1.13 - 7.71；P = 0.03）。
MVP心电图风险评分可能是接受经皮PFO封堵术患者术后早期房颤发生的独立预测指标。
