What can be expected for patients with aortic stenosis and atrial fibrillation regarding peak systolic aortic velocity?

In patients with aortic stenosis and atrial fibrillation, the dynamics of blood flow can lead to variations in hemodynamic parameters, particularly the peak systolic aortic velocity. Atrial fibrillation results in irregular heart rhythms, which leads to varying R-R intervals (the time between heartbeats).

When there are long R-R intervals, the heart has more time to fill during diastole, which can subsequently increase the volume of blood ejected during systole. As a result of this increased ventricular filling volume, the peak systolic aortic velocity may elevate due to the larger stroke volume being pushed through the stenotic aortic valve. Thus, in the context of long R-R intervals—when the heart has had prolonged periods of filling—one can expect a higher peak systolic aortic velocity.

This relationship highlights the importance of understanding the impact of rhythm disturbances like atrial fibrillation on cardiac hemodynamics, particularly in patients with structural heart issues such as aortic stenosis, where the degree of stenosis already compounds the challenges in blood flow dynamics.