Thrombogenicity of radiofrequency lesions: Results with serial D-dimer determinations

Abstract

As reflected by elevated plasma D-dimer levels, RF ablation has a thrombogenic effect that persists through 48 h after the procedure. This effect needs to be taken into account when considering antithrombotic therapy in patients undergoing RF ablation.

Delayed Thrombogenesis Following Radiofrequency Catheter Ablation.

“…7 Another report showed that platelet aggregability increased during RF current delivery, 9 and Manolis et al showed that RF-CA provoked an elevation in the D-dimer concentration by 48 h after the procedure. 8 These previous studies have not fully elucidated the influence of the RF current on thrombus formation nor have they observed the delayed phase of thrombogenesis. Previous experimental studies have shown histological changes in association with RF-CA, 10,18,19 one of which is thrombus formation 7 days after the procedure.…”

Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease

“…Manolis et al 540 and Michelucci et al 541 separately studied activation of the clotting system, comparing patients who had routine electrophysiology studies with patients who had RFCA procedures. Spontaneous platelet aggregation, prothrombin fragment 1+2, thrombin-antithrombin complex, and d-dimer levels increased in all patients.…”

Comparison of hemostatic activation created by right‐ and left‐heart radiofrequency catheter ablation

“…The TAT level then returned to baseline level 48 h after both left-heart and right-heart procedures, suggesting that the RF ablation procedure itself induced the active thrombogenic process, which is consistent with previous findings in the literature. 4,7 D-dimer assay is recognized as highly sensitive (> 90%) with a high negative predictive value, making it a very useful clinical tool for detecting vascular thrombosis. 4 Although the elevation of D-dimer may result from the peripheral effects induced by sheath insertion and catheter manipulation, 10 the marked elevation of D-dimer in this study mainly resulted from the central effects of RF ablation application, which caused endomyocardial injury and higher temperature.…”

“…4,7 D-dimer assay is recognized as highly sensitive (> 90%) with a high negative predictive value, making it a very useful clinical tool for detecting vascular thrombosis. 4 Although the elevation of D-dimer may result from the peripheral effects induced by sheath insertion and catheter manipulation, 10 the marked elevation of D-dimer in this study mainly resulted from the central effects of RF ablation application, which caused endomyocardial injury and higher temperature. 7,16 In contrast to TAT, which returned to its baseline level at 48 h post procedure, the plasma level of D-dimer remained elevated in both groups and was slightly higher in the AVNRT group at 48 h post procedure.…”

“…3 Previous studies have addressed the effect of RF ablation on the status of hemostasis and fibrinolysis systems. 4 Pharmacologic intervention has been shown to reduce thrombogenic potential and endothelial dysfunction in high-risk patients, especially those afflicted with atrial fibrillation. 5,6 In addition, variation in study cohorts often makes interpreting the actual risk of thrombogenicity among different groups of patients difficult.…”