Right ventricular dysfunction was present in 14.5% of symptomatic AF patients and was associated with lower cardiorespiratory fitness (VO2peak 17.9 vs 21.1 mL/kg/min, p=0.01).
Cross-Sectional (n=241)
Does right ventricular dysfunction associate with reduced cardiorespiratory fitness and increased symptom burden in patients with symptomatic atrial fibrillation and preserved LVEF?
In patients with symptomatic AF and preserved LVEF, right ventricular dysfunction is present in 14.5% of cases and is associated with significantly reduced cardiorespiratory fitness, though not with increased symptom severity.
Absolute Event Rate: 17.9% vs 21.1%
p-value: p=0.01
BackgroundAssessment of left ventricular (LV) function is an essential component of guideline-recommended management of atrial fibrillation (AF).However, the role and implications of right ventricular (RV) dysfunction in AF is poorly understood. ObjectiveTo determine the prevalence of RV dysfunction and evaluate its association with cardiorespiratory fitness (CRF) and symptom burden in patients with symptomatic AF. MethodsConsecutive adults with symptomatic paroxysmal or persistent AF and preserved LV ejection fraction scheduled for catheter ablation underwent transthoracic echocardiography, cardiopulmonary exercise testing and AF symptom assessment.RV dysfunction was defined as tricuspid annular plane systolic excursion 1.7cm and/or tissue Doppler s' velocity 9.5cm/s.Cardiorespiratory fitness was determined by peak oxygen consumption (VO 2peak ) during cardiopulmonary exercise testing. ResultsAmong 241 patients (mean age 6610 years; 25% female), RV dysfunction was present in 35 patients (14.5%) despite preserved LV systolic function.Patients with RV dysfunction had lower CRF (VO 2peak 17.96.7 vs 21.16.6mL/kg/min,p=0.01) independent of rhythm, with a greater proportion exhibiting severely reduced CRF (VO 2peak <16mL/kg/min: 43% vs 23%, p=0.026).There was no association between RV dysfunction and AF symptom severity (p=0.59).Structural chamber dimensions were comparable.Patients with RV dysfunction demonstrated higher E/e' (p=0.006),lower left atrial reservoir strain (p<0.001) and LV global longitudinal strain (p<0.001).
Dziano et al. (2026) conducted a cross-sectional in Symptomatic paroxysmal or persistent atrial fibrillation with preserved LV ejection fraction (n=241). Right ventricular (RV) dysfunction vs. Preserved RV function was evaluated on Cardiorespiratory fitness (peak oxygen consumption, VO2peak) (p=0.01). Right ventricular dysfunction was present in 14.5% of symptomatic AF patients and was associated with lower cardiorespiratory fitness (VO2peak 17.9 vs 21.1 mL/kg/min, p=0.01).