ArticleJournal of the American Heart Association2026
Right Ventricular-Pulmonary Artery Coupling in Patients With Atrial Fibrillation and Changes After Catheter Ablation.
Article in Journal of the American Heart Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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20 authors.
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Abstract
backgroundAtrial fibrillation (AF) is a predominant risk factor for heart failure, even in patients with preserved left ventricular ejection fraction. Emerging evidence suggests the significance of right ventricular-pulmonary artery (RV-PA) uncoupling in heart failure occurrence. We aimed to elucidate the prevalence and associated factors of RV-PA uncoupling and the efficacy of catheter ablation (CA) for RV-PA adaptation in patients with AF without history of heart failure.
methodsWe studied 164 patients with AF free of heart failure who had normal left ventricular ejection fraction and underwent first CA. Echocardiography was performed before and 6 months after CA. RV-PA coupling was calculated from the ratio of tricuspid annular plane systolic excursion to PA systolic pressure. Abnormal RV-PA coupling was defined as tricuspid annular plane systolic excursion/PA systolic pressure <0.70 mm/mm Hg.
resultsAmong the participants, 32 (19.5%) patients were classified as having abnormal RV-PA coupling. The abnormal RV-PA coupling group was older, and had higher prevalence of persistent AF, higher CRP (C-reactive protein) and B-type natriuretic peptide levels than the normal RV-PA coupling group. Multivariable analysis demonstrated that an elevated CRP level was significantly associated with RV-PA uncoupling (
conclusionsApproximately 20% of patients with AF with preserved left ventricular ejection fraction had abnormal RV-PA coupling, and CA improved RV-PA coupling status, whereas its benefits were observed in patients free from recurrent AF.
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