Speakers - 2026

Title: Pulse Wave Velocity for Atrial Fibrillation Risk Stratification: A Scoping Review of Clinical Relevance

Abstract

Background: Atrial fibrillation (AF) is the most common sustained arrhythmia and is associated with stroke, heart failure, and increased mortality. Early identification of higher-risk patients remains a clinical priority. Pulse wave velocity (PWV) is a rapid, noninvasive measure of arterial stiffness used in vascular risk assessment; whether it provides clinically useful information for AF development or outcomes is unclear.

Methods: A scoping review was conducted using systematic literature search methods. MEDLINE, EMBASE, Web of Science, and CINAHL were searched for English-language studies (2014-2024). Eligible studies included adult human populations with AF reporting ≥1 PWV measurement. Systematic reviews/meta-analyses, case reports, animal studies, and abstract-only publications were excluded.

Results: Twenty-six studies met inclusion criteria. Central PWV measures (carotid-femoral/aortic PWV) showed more consistent associations with AF phenotypes and outcomes than peripheral indices. Evidence for PWV as an independent predictor of incident AF was mixed after adjustment for traditional risk factors, suggesting limited standalone screening performance. In contrast, in established AF and perioperative contexts, higher PWV more consistently tracked disease burden, and adverse cardiovascular outcomes, supporting potential use as a clinical risk stratification adjunct.

Conclusion: Current evidence supports an association between arterial stiffness and AF, with PWV showing greatest potential as an adjunct tool for prognostic and perioperative risk stratification rather than general-population screening, with potential applicability in perioperative and high-risk cardiovascular populations. Prospective studies using standardized AF-specific PWV protocols should test whether PWV improves incident AF prediction and perioperative risk assessment when added to established clinical and echocardiographic models.