Radiofrequency Catheter Ablation of Atrial Flutter Induces the Release of Platelet and Leukocyte‐Derived Procoagulant Microparticles and a Prothrombotic State

Jesel, Laurence; Morel, Olivier; Pynn, S.; Radulescu, Bogdan; Grunebaum, Lélia; Freyssinet, Jean‐Marie; Ohlmann, Patrick; Bareiss, P.; Toti, Florence; Chauvin, Michel

doi:10.1111/j.1540-8159.2008.02202.x

Cited by 10 publications

(7 citation statements)

References 27 publications

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“…A study of patients having RFCA for AFL demonstrated that ablation causes release of procoagulant microparticles derived from platelets and leukocytes but not from endothelium. 543 The thrombotic complications of RFCA reported in multiple adult studies were reviewed by Zhou et al 544 The thromboembolic complication rate ranged from 0% to 2%. Most of these studies reported systemic heparinization during the ablations, particularly when ablating on the left side.…”

Section: Radiofrequency Catheter Ablationmentioning

confidence: 99%

Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease

Giglia¹,

Massicotte²,

Tweddell³

et al. 2013

Circulation

283

245

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Section: Radiofrequency Catheter Ablationmentioning

confidence: 99%

Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease

Giglia¹,

Massicotte²,

Tweddell³

et al. 2013

Circulation

283

245

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“…Because the number of thromboembolic complications of RFA is low, identification of the risk factors is difficult and the significance of the pathophysiological mechanisms of hemostasis activation during RFA has not been definitively established in studies published to date. T0 before insertion of sheaths, T1 end of EPS, T2 30 min after completion of RFA, DD D-dimers, TAT thrombin-antithrombin III, PAI-1 plasminogen activator inhibitor type 1, t-PA tissue-type plasminogen activator, CPAi circulating platelet aggregates index, LCL lower confidence level, UCL upper confidence level Potential mechanisms of thrombogenesis during ablation procedures are multiple and include endothelial disruption, coagulation necrosis, electroporation injury, mechanical damage of the vessel wall, and heating of circulating blood elements by RF energy [9][10][11][12][13][14][15][16][17][18]. Sasano et al [19] concluded that the thrombogenesis caused by RFA has 2 phases; in the acute phase hemostasis activation occurs during placement of the catheters and in the delayed phase thrombogenesis is the result of endothelial damage caused by the RF current.…”

Section: Discussionmentioning

confidence: 99%

Hemostatic changes before and during electrophysiologic study and radiofrequency catheter ablation

Pařízek¹,

Haman²,

Pleskot³

et al. 2011

Int J Hematol

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We sought to investigate specific hemostasis activation markers during electrophysiologic study (EPS) with consequent radiofrequency catheter ablation (RFA). Sixty patients were studied prospectively during routine EPS with RFA for paroxysmal supraventricular tachycardia. Blood samples were drawn before the insertion of venous sheaths (T0), at the end of EPS (T1), and 30 min after completion of RFA (T2). To study coagulation and fibrinolytic and platelet activity, we measured concentrations of thrombin-antithrombin III (TAT), D-dimers (DD), plasminogen activator inhibitor type 1 (PAI-1), tissue-type plasminogen activator (t-PA), and circulating platelet aggregates. The results are expressed as median and show 95% confidence levels. Levels of DD increased from 0.24 mg/L at T0 to 0.37 mg/L at T1 (P < 0.001) and to 0.59 mg/L at T2 (P < 0.001). TAT levels increased from 5.29 μg/L at T0 to 35.80 μg/L at T1 (P < 0.001) and decreased to 26.30 μg/L at T2 (P < 0.001). PAI-1 concentration decreased from 30.10 μg/L at T0 to 26.4 μg/L at T1 (P < 0.001). t-PA at T2 increased to 5.10 μg/L from 4.75 μg/L at T1 (P = 0.001). No other differences between corresponding medians were statistically significant (P > 0.05). We found that concentrations of DD at T2 versus T1 depended on the number of radiofrequency energy applications (r (S) = 0.387; P = 0.002). Marked platelet activation was observed from the start of the procedure, without changes during the procedure.

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“…A number of studies have demonstrated RFCA to be associated with pre-thrombosis 4 33 . Thrombosis may occur inside the heart chamber or in artery and vein blood vessels in the peripheral regions after RFCA 34 .…”

Section: Discussionmentioning

confidence: 99%

“…Although favorable outcomes have been reported following the use of RFCA, some potential serious complications are still evident. Significant risks include thromboembolic complications, vein vascular endothelial injuries, infection, bleeding, cardiac perforation with or without cardiac tamponade, valvular damage, and risks associated with the procedure or sometimes with the radiation itself 2 4 . It has been reported that RFCA may result in the formation of asymptomatic lower limb deep vein thrombosis (LDVT) 5 6 .…”

mentioning

confidence: 99%

Prevention and Treatment of Lower Limb Deep Vein Thrombosis after Radiofrequency Catheter Ablation: Results of a Prospective active controlled Study

Zhang

et al. 2016

Sci Rep

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We conducted a prospective, single-center, active controlled study from July 2013 to January 2015, in Chinese patients with rapid ventricular arrhythmia who had received radiofrequency catheter ablation (RFCA) treatment to determine formation of lower extremity deep vein thrombosis (LDVT) post RFCA procedure, and evaluated the effect of rivaroxaban on LDVT. Patients with asymptomatic pulmonary thromboembolism who had not received any other anticoagulant and had received no more than 36 hours of treatment with unfractionated heparin were included. Post RFCA procedure, patients received either rivaroxaban (10 mg/d for 14 days beginning 2–3 hours post-operation; n = 86) or aspirin (100 mg/d for 3 months beginning 2–3 hours post-operation; n = 90). The primary outcome was a composite of LDVT occurrence, change in diameter of femoral veins, and safety outcomes that were analyzed based on major or minor bleeding events. In addition, blood flow velocity was determined. No complete occlusive thrombus or bleeding events were reported with either of the group. The lower incidence rate of non-occluded thrombus in rivaroxaban (5.8%) compared to the aspirin group (16.7%) indicates rivaroxaban may be administered post-RFCA to prevent and treat femoral venous thrombosis in a secure and effective way with a faster inset of action than standard aspirin therapy.

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Radiofrequency Catheter Ablation of Atrial Flutter Induces the Release of Platelet and Leukocyte‐Derived Procoagulant Microparticles and a Prothrombotic State

Cited by 10 publications

References 27 publications

Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease

Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease

Hemostatic changes before and during electrophysiologic study and radiofrequency catheter ablation

Prevention and Treatment of Lower Limb Deep Vein Thrombosis after Radiofrequency Catheter Ablation: Results of a Prospective active controlled Study

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