Clinical & Experimental Cardiology
Open Access
ISSN: 2155-9880
+44 1300 500008
ISSN: 2155-9880
+44 1300 500008
Scott Willoughby
Posters-Accepted Abstracts: J Clin Exp Cardiolog
Atrial fibrillation (AF) is a known prothrombotic state, which is associated with endothelial dysfunction, increased platelet reactivity and hypercoagulation. However, little is known whether restoration of sinus rhythm by radiofrequency (RF) ablation acutely improves inflammation, myocardial injury and prothrombotic tendencies. Ninety consecutive patients undergoing elective RF catheter ablation for AF were recruited prospectively. Clinical, echocardiographic and procedural details were recorded. High-sensitivity CRP (hs-CRP), white cell count (WCC), neutrophil count, Troponin-T, creatine kinase (CK) and creatine kinase-MB (CKMB), fibrinogen and D-Dimer were measured at baseline, 1, 2, 3, 7 days and 1 month post ablation. AF recurrence was documented on physician review at 3 days, 1, 3 and 6 months post procedure. The cohort comprised 53.3% paroxysmal, 34.4% persistent and 12.2% long-standing persistent AF patients. Hs-CRP peaked and was significantly elevated at days 2 (36.89 � 34.87 vs. 2.57 � 2.16 mg/L, p<0.05) and 3 (44.29 � 37.37 vs. 2.57 � 2.16 mg/L, p<0.05) post ablation compared to baseline. Troponin-T (1.61 � 1.07 vs. 0.05 � 0.08 μg/L, p<0.05) and CKMB (10.65 � 5.10 vs. 3.21 � 1.20 μg/L) peaked at day 1 post procedure. Fibrinogen (4.71 � 1.42 vs. 3.11 � 0.61 g/L, p<0.05) and D-Dimer (0.58 � 0.46 vs. 0.30 � 0.18 FEU, p<0.05) levels were significantly elevated at 1 week post procedure. Hs-CRP elevation correlated with Troponin-T (rs=0.35, p<0.02) and fibrinogen (rs=0.59, p<0.01) elevation. Increased hs-CRP, Troponin-T and CKMB elevation post ablation was significantly associated with AF recurrence within 3 days post procedure and increased fibrinogen elevation with AF recurrence at 3 days and 1 month. Patients undergoing RF ablation for AF exhibit an inflammatory response and myocardial injury within the first few days post ablation. Increased inflammatory response is linked to immediate AF recurrence. Prothrombotic markers are elevated one week post ablation, may be driven by inflammation and explain the increased risk of early thrombotic events post AF ablation. Targeting the inflammatory response during this peri-procedural time frame could aid in maintenance of sinus rhythm post AF ablation.