Left atrial function, inflammation, and prothrombotic response after radiofrequency ablation for atrial fibrillation

Yin, Guangli; Xie, Ruiqin; You, Long; Yin, Hang; Sun, Yucui; Wu, Jinglan; Zhao, Yansha; Geng, Xin; Zhang, Yanan

doi:10.1016/j.jcma.2017.12.001

Cited by 12 publications

(7 citation statements)

References 28 publications

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“…Local overheating caused by electrical discharge during RFA results in local myocardial tissue damage and inflammation, which activate a coagulation cascade and promote platelet aggregation [ 3 , 5 ]. Besides, although AF turns into sinus rhythm after RFA, left atrium function is impaired acutely following AF catheter ablation, resulting in slow blood flow in the left atrium, and thus prone to thrombosis in the left atrium [ 6 , 7 ]. By using intracardiac echocardiography, Maleki et al found that most of the intraoperative thrombus originated around the sheath placed in the left atrium during the operation and could form almost immediately after the sheath enters the left atrium [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Superior mesenteric artery embolism after radiofrequency ablation in regularly anticoagulated patients with paroxysmal atrial fibrillation: a case report

Jing

Chen

et al. 2023

BMC Cardiovasc Disord

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Background Superior mesenteric artery embolism (SMAE) is a rare cause of acute abdomen, and the fatality rate is extremely high if it is not diagnosed and treated in time. Due to the lack of knowledge and experience of nonspecialist physicians, it is easy to misdiagnose. Radiofrequency ablation (RFA) has become the first-line treatment strategy for atrial fibrillation (AF). Thromboembolic events are some of the major complications after RFA, whereas SMAE is rarely reported. Case presentation A 70 year-old woman with paroxysmal AF who regularly took anticoagulant drugs for 3 months experienced abdominal pain after RFA. At the outset, she was misdiagnosed as mechanical intestinal obstruction. When the patient presented with blood in the stool, abdominal enhancement computed tomography was conducted and showed a small bowel perforation. Immediate laparotomy was performed, and the final diagnosis was SMAE. Conclusion It is suggested that for unexplained abdominal pain after RFA of AF, the possibility of SMAE should be considered, and a targeted examination should be carried out in time to confirm the diagnosis and give appropriate treatment.

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Section: Discussionmentioning

confidence: 99%

Superior mesenteric artery embolism after radiofrequency ablation in regularly anticoagulated patients with paroxysmal atrial fibrillation: a case report

Jing

Chen

et al. 2023

BMC Cardiovasc Disord

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“…Whereas inflammatory response is common and occurs after RF ablations and cryoablations as well, the change in factors associated with thrombosis is a matter of debate. D‐dimer and fibrinogen have been described to be elevated after PVI within a week after the procedure 5,22,23 . However, factors associated with platelet function have shown a controversial trend.…”

Section: Discussionmentioning

confidence: 99%

Measurements of immature platelet fraction and inflammatory markers in atrial fibrillation patients ‐ Does persistency or ablation affect results?

Brezinov

Sevylia

Rahkovich

et al. 2020

Int J Lab Hematology

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Purpose Atrial fibrillation (AF) is associated with platelet hyperactivity and a higher proportion of immature platelets. We aimed to examine whether immature platelet fraction (IPF) and inflammatory markers differ between AF types and whether they are affected by ablation. Methods A prospective study included patients with atrial fibrillation/flutter (AFL). We excluded patients with hematologic, inflammatory, or acute coronary states. Blood samples for IPF, white blood cells (WBC), neutrophil‐to‐lymphocyte ratio (NLR), and C‐reactive protein (CRP) were collected at baseline, within one‐hour postablation in those undergoing ablations, and the day after ablation. IPF was measured by an autoanalyzer (Sysmex 2100 XE). Results One hundred and four patients were included (paroxysmal AF‐63, persistent AF‐36, AF and AFL‐7, AFL alone‐5), (Mean age 67.7 ± 12.8 years, 54.8% male, CHA2D2‐VASC2 3.2 ± 1.8). Seventy‐two patients underwent ablation (cryoballoon AF ablation‐60, AFL radiofrequency ablation‐5, both‐7). There was no difference between paroxysmal and persistent AF regarding baseline markers. There was a significant change in the following parameters after ablation: WBC (baseline 6.9 ± 2.0, 1‐h post 8.0 ± 2.4, and 1‐day post 9.0 ± 2.8 ×109/L), NLR (2.9 ± 2.2, 3.0 ± 2.4, 4.2 ± 2.9, respectively), and CRP (3.6 ± 3.7, 3.6 ± 3.5, 12.4 ± 9.0 mg/L, respectively) (P < .05 for all). However, there were no differences in immature platelet count (8.6 ± 4.8, 8.5 ± 4.9, 8.4 ± 5.2 ×109/L) or IPF (4.6 ± 3.2, 4.7 ± 3.3, 4.9 ± 3.6%) from baseline to postablation (p = NS). Conclusions AF persistency does not affect IPF and inflammation. In patients undergoing cryoablation of AF, there is a postablation inflammatory process; however, platelet activation is probably not affected.

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“…If not, RFA was applied for additional points. More details of the standard ablation technique can be obtained from our previously published clinical trials 12,13 . All steps of ablation were performed by a single group of four experienced ablationists led by a Chief physician (Dr. Ruiqin Xie).…”

Section: Methodsmentioning

confidence: 99%

The immediate trends in atrial electrical remodeling for paroxysmal atrial fibrillation across different modes of catheter ablation

Hou

Feng

Yang

et al. 2021

Clinical Cardiology

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Background Catheter ablation has emerged as a major strategy for paroxysmal atrial fibrillation (PAF). Atrial electrical remodeling (AER) plays a critical role in the recurrence of PAF after ablation. Hypothesis To characterize the immediate trends of AER during ablations in patients with PAF, and assess the relationship between immediate trends and recurrence. Methods We performed this prospective observational study of 135 patients to investigate AER following three ablation modes: radiofrequency ablation (RFA), cryoablation (CA) and 3D mapping‐guided cryoablation (3D‐CA). The atrial effective refractory period (AERP) and atrial conduction time (ACT) were measured via electrophysiology before and immediately after ablation, and P‐wave indices were measured via electrocardiography before and within 24 h after ablation. Follow‐up visits were conducted for at least 1 year or until relapse. Results Different approaches of ablation caused a fairly significant increase in the shortest P‐wave duration and AERP in both the proximal coronary sinus (PCS) and distal coronary sinus (DCS) but caused a shortened P‐wave dispersion. No different effect was found at the AERP among the three modes. Compared to patients who received CA, among patients who received RFA, a significant reduction in total ACT and right ACT was seen. Statistically, there was a weakly positive association between changes in total ACT and early recurrence. Conclusions Injury during ablation for PAF was associated with an increase in the AERP but not in the ACT. Total ACT and right ACT were shorter after RFA than after CA. The increase in total ACT were slightly predictive of early recurrence.

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Left atrial function, inflammation, and prothrombotic response after radiofrequency ablation for atrial fibrillation

Cited by 12 publications

References 28 publications

Superior mesenteric artery embolism after radiofrequency ablation in regularly anticoagulated patients with paroxysmal atrial fibrillation: a case report

Superior mesenteric artery embolism after radiofrequency ablation in regularly anticoagulated patients with paroxysmal atrial fibrillation: a case report

Measurements of immature platelet fraction and inflammatory markers in atrial fibrillation patients ‐ Does persistency or ablation affect results?

The immediate trends in atrial electrical remodeling for paroxysmal atrial fibrillation across different modes of catheter ablation

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