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Updated: Oct 8, 2025

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

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Left Ventricular Systolic Dysfunction Due to Atrial Fibrillation: Clinical and Echocardiographic Predictors

Erez Marcusohn1, Ofer Kobo2, Maria Postnikov1

  • 1Department of Cardiology, Rambam Health Care Campus Haifa, Israel.

Cardiac Failure Review
|December 24, 2021
PubMed

Insights

Men with rapid heart rates during atrial fibrillation (AF) or atrial flutter (AFL) are more prone to reduced left ventricular ejection fraction (LVEF). Prosthetic valve history also increases LVEF reduction risk during AF/AFL.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiomyopathy Research

Background:

  • Atrial fibrillation (AF)-induced cardiomyopathy diagnosis is complex, requiring exclusion of other causes and assessment of left ventricular (LV) function recovery post-sinus rhythm restoration.
  • Predicting systolic dysfunction in patients with atrial tachyarrhythmia is crucial for timely intervention.

Purpose of the Study:

  • To identify clinical and echocardiographic predictors of developing cardiomyopathy with systolic dysfunction in patients experiencing atrial tachyarrhythmia.
  • To understand risk factors associated with left ventricular ejection fraction (LVEF) reduction during paroxysmal AF or atrial flutter (AFL).

Main Methods:

  • Retrospective analysis of 482 patients with baseline preserved LVEF (>50%) in sinus rhythm.
  • Comparison of patients with reduced LVEF versus preserved LVEF during precardioversion transesophageal echocardiography for AF/AFL.
  • Identification of clinical and echocardiographic parameters associated with LVEF deterioration.

Main Results:

  • 17% of patients (80/482) experienced reduced LVEF during AF/AFL.
  • Male sex and rapid ventricular response during AF/AFL were significantly associated with reduced LVEF.
  • History of prosthetic valves, tricuspid regurgitation, and right ventricular dysfunction were identified as risk factors for LVEF reduction.

Conclusions:

  • Male patients with rapid ventricular response during paroxysmal AF or AFL are at higher risk for LVEF reduction.
  • Patients with prosthetic valves are also susceptible to LVEF reduction during AF/AFL.
  • Tricuspid regurgitation and right ventricular dysfunction may suggest prolonged AF/AFL with associated LVEF decline.

Keywords:
AFheart failure with reduced ejection fractiontachycardia induced cardiomyopathy

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