Og. Anfinsen et al., The activation of platelet function, coagulation, and fibrinolysis during radiofrequency catheter ablation in heparinized patients, J CARD ELEC, 10(4), 1999, pp. 503-512
Citations number
27
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Hemostatic Activation during RF Ablation. Introduction: Catheter ablation m
ay be complicated by clinical thromboembolism in about 1% of patients.
Methods and Results: We studied the activation of coagulation (prothrombin
fragment 1+2 [PF1+2]), platelets (beta-thromboglobulin [beta-TG])) and fibr
inolysis (plasmin-antiplasmin complexes [PAP] and D-dimer) during radiofreq
uency (RF) ablation in 13 patients. They received heparin 100 U/kg intraven
ously after the initial electrophysiologic study, prior to the delivery of
RF current; thereafter 1,000 U/hour throughout the procedure. PF1+2 increas
ed fourfold (P < 0.001) during the diagnostic study, but gradually declined
to upper reference value during heparin administration. There was a strong
correlation between procedure duration prior to heparin bolus (range 39 to
173 min); and (a) the maximal rise of PF1+2 (r = 0.83, P < 0.001) and (b)
the increase of PF1+2 from baseline to end of the procedure (r = 0.74, P =
0.004). There was no correlation between postheparin changes of PF1+2 and (
a) postheparin procedure duration (range 40 to 317 min), (b) number of RF p
ulses (range 1 to 16), or (c) RF current duration (range 46 to 687 sec). Pl
asma beta-TG concentration showed similar trends. Fibrinolytic activity inc
reased moderately from baseline until heparin administration; then remained
around the upper reference values. 1)AP at the end of procedure and D-dime
r at the time of heparin administration both correlated with preheparin pro
cedure duration (r = 0.70, P = 0.007 and r = 0.69, P = 0.01, respectively).
All parameters were normal the next morning.
Conclusion: Procedure duration prior to heparin administration, and not the
delivery of RF current per se, determines activation of hemostasis and fib
rinolysis during RF ablation.