Delayed anaerobic threshold in heart failure patients with atrial fibrillation

Pietro Palermo, Damiano Magrì, Susanna Sciomer, Elisa Stefanini, Cecilia Agalbato, Elisa Compagnino, Cristina M. Chircu, Francesco Maffessanti, Minodora Teodoru, Piergiuseppe Agostoni

Research output: Contribution to journalArticlepeer-review


Purpose: To assess whether atrial fibrillation (AF) in heart failure (HF) affects oxygen uptake at anaerobic threshold (V E O 2 AT) and heart rate (HR) kinetics. METHODS: A total of 15 patients with HF and AF and 18 with HF and sinus rhythm (SR) performed a maximal incremental and 2 constant workload cycle ergometer cardiopulmonary exercise tests (below and above AT, at 25% and 75% of maximal workload, respectively). At constant workload tests, kinetics of VO2 and HR were assessed by calculating time constant (τ).RESULTS: HF patients with AF showed a similar peak VO2 to those with SR (16.7±4.5 mL/kg/min vs 16.6±3.9 mL/kg/min). However, VO2 AT (11.3±2.9 mL/kg/min vs 9.3±2.8 mL/kg/min; P 2 below and above AT were not significantly different.CONCLUSIONS: In HF patients with AF, despite a similar peak VO2 compared with patients with HF and SR, VO2 AT is higher because of a higher HR and a greater HR increase during exercise. One postulated mechanism would be a greater cardiac output increase at the beginning of exercise in HF patients with AF. The delayed AT generates uncertainty about the meaning of a VO2 value at AT in HF patients with AF, because a higher AT is usually associated with better performance and a better prognosis.

Original languageEnglish
Pages (from-to)174-179
Number of pages6
JournalJournal of Cardiopulmonary Rehabilitation and Prevention
Issue number3
Publication statusPublished - May 25 2016


  • Anaerobic threshold
  • Atrial fibrillation
  • Heart rate
  • Oxygen uptake

ASJC Scopus subject areas

  • Rehabilitation
  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine


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