The Activation of Haemostasis during Radiofrequency Catheter Ablation
Pařízek P.1, Haman L.1, Malý J.2, Pecka M.2, Hodač M.2, Bukač J.3, Stránský P.3, Malý R.1, Duda J.1, Pleskot M.1
1Katedra interních oborů Lékařské fakulty UK a FN, Hradec Králové, vedoucí prof. MUDr. J. Malý, CSc., I. interní klinika Lékařské fakulty UK a FN, Hradec Králové, přednosta doc. MUDr. M. Pleskot, CSc. 2Katedra interních oborů Lékařské fakulty UK a FN, Hradec Králové, vedoucí prof. MUDr. J. Malý, CSc., II. interní klinika Lékařské fakulty UK a FN, Hradec Králové, přednosta prof. MUDr. J. Malý, CSc. 3Katedra lékařské biofyziky Lékařské fakulty UK, Hradec Králové, vedoucí prof. MUDr. P. Stránský, CSc. |
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Summary:
The aim of the study was to investigate chosen haemostasis activation markers during electrophysiologic
study (EPS) with consequent radiofrequency catheter ablation (RFA). Sixty-three patients
were studied prospectively. Indications for EPS and RFA were supraventricular
tachycardias with the arrhythmogenic substrate located in the right atrium. Blood samples were
drawn 24 hours before the procedure (T -1), at the beginning of the procedure (T0), at the end of
EPS (T1), 30 minutes after completion of RFA (T2), and 24 hours after the procedure (T3). To study
coagulation, fibrinolytic and platelet activation were measured concentrations of thrombin-antithrombin
III (TAT), D-dimers (DD), platelet count and parameters, and circulating platelet aggregates
(CPAi). During the EPS and RFA, TAT levels increased from the baseline 5.03 ± 2.53 g/l (T
-1) to 12.90 ± 12.83 g/l at T0 (p < 0.001) to 36.07 ± 15.59 g/l at T1 (p < 0.001) and decreased to 28.85 ±
13.14 g/l at T2 (p < 0.001). Levels of DD increased from 0.30 ± 0.20 mg/l at T0 to 0.44 ± 0.25 mg/l at
T1 (p < 0.001) and to 0.87 ± 0.74 mg/l at T2 (p < 0.001). The number of platelets was significantly
decreased (-13.7 %) before and during the procedure (T -1 vs. T3; p < 0.001). Marked platelet
activation (CPAi 0.62 ± 0.32) was observed before the procedure opposite to the physiological
values (CPAi 1.0 ± 0.1), without changes during the procedure (CPAi at T2 0.69 ± 0.23). Our results
confirmed activation of several haemostasis parameters during EPS and RFA, and support eligibility
of the antithrombotic prevention in patients indicated for EPS and RFA.
Key words:
Haemostasis - Electrophysiology - Radiofrequency catheter ablation - Arrhythmia
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