Right ventricular systolic function in atrial fibrillation

Right ventricular (RV) dysfunction in patients with atrial fibrillation (AF) remains an underexplored area. Its prognostic impact is well recognised in various cardiovascular diseases. However, the incidence and predictors of RV failure in patients with AF have not yet been clearly defined.

Our aim is to report the incidence and predictors of right ventricular dysfunction in AF patients without structural heart disease.

A retrospective cohort study was conducted, including 146 patients with AF and no structural heart disease. Patients were classified as having paroxysmal or non-paroxysmal AF. RV dysfunction was defined by TAPSE <17 mm and/or S’ <10 cm/s. Incidence was estimated using the Kaplan-Meier method, and predictive factors were identified using Cox proportional hazards models.

Over a follow-up period of 3.6 years, 21 patients (14.4%) developed RV dysfunction. No patient died, and 33 experienced heart failure. The main predictors for RV dysfunction were male sex (HR: 18.15; p<0.001), hypertension (HR: 4.1; p=0.031), and a history of heart failure (HR: 5.02; p=0.046). Patients who developed RV dysfunction had a higher estimated pulmonary artery systolic pressure (mean 42 mmHg vs. 36 mmHg, p=0.01) and experienced a greater incidence of heart failure during follow-up (20% vs. 38.1%, p=0.0287).

The incidence of RV dysfunction in patients with AF is considerable. Male patients, those with hypertension, and those with a history of heart failure were at higher risk. The development of RV dysfunction was associated with an increased incidence of heart failure during follow-up.

Baseline characteristics