Fig. 3

Typical right atrial pressure tracings at rest (a), note the large single regurgitant systolic wave and during peak exercise (b) in a patient with AF-FTR. Mean atrial pressure is significantly elevated at rest but raises even further with exercise. Of notice there is no drop in RA pressure during inspiration (Kussmaul sign) despite reduction in PCWP associated with decreasing intrathoracic pressure (C + D) which is especially pronounced at peak exercise