ERACEing the Risk of Cerebral Embolism From Atrial Fibrillation Ablation

Platelet Activation After Radiofrequency Ablation in Atrial Fibrillation

“…8 A substantial reduction of asymptomatic cerebral emboli has been achieved by using a multielectrode RF and by lowering the introduction of air into the left atrium during the catheter insertion and removal.…”

“…9,10 The activation of the clotting system is another critical issue, which is related to the duration of the RF procedure and concurs to asymptomatic cerebral emboli. 8,11 In this issue of Circulation, Stazzi et al 12 address the question as to whether platelet activation is also implicated in the prothrombotic state occurring after RF ablation and if remote ischemic preconditioning (IPC) is able to prevent it. The background to explore this issue was based on a previous study that investigated the effect of warfarin in association with aspirin, an inhibitor of platelet thromboxane A 2 via COX1 acetylation, in 207 warfarin-treated AF patients undergoing left atrial ablation.…”

Atrial Fibrillation and Stroke

“…Many operators withdraw the long transseptal sheath into the right atrium during catheter manipulation in the left atrium. 40 …”