ABSTRACT
OBJECTIVE: To determine an influence of radiofrequency ablation on changes in coagulation system. MATERIAL AND METHODS: We investigated 30 patients with cardiac arrhythmias. Platelet aggregation, fibrinogen and D-dimer level were analyzed before, right after, 24 and 72 h after radiofrequency ablation. Platelet aggregation was explored in whole blood and platelet-rich plasma using adenosine diphosphate (ADP), epinephrine, and collagen for induction. RESULTS: Platelet aggregation induced by ADP and collagen in whole blood plasma increased significantly (P<0.01) (by 45% and 43%, respectively) in 24 h after radiofrequency ablation and remained increased in 72 h after radiofrequency ablation (by 11% and 35%, respectively) (P<0.01) as compared with baseline results. Spontaneous aggregation of platelet-rich plasma as well as ADP- and collagen-induced platelet aggregation tended to decrease right after radiofrequency ablation. Epinephrine-induced platelet aggregation significantly decreased by 17.5% after radiofrequency ablation (P<0.01) and started to increase in 24 h after radiofrequency ablation. In 72 h after radiofrequency ablation, platelet aggregation induced by different agonists increased by 7-45% significantly (P<0.05), and values were higher than baseline ones. Fibrinogen level after radiofrequency ablation did not differ from that of the baseline (3.08+/-0.7 g/L), but D-dimer level increased significantly (from 0.39+/-0.3 to 1.29+/-2.4 mg/L, P<0.01). In 24 h after radiofrequency ablation, an increase in fibrinogen level and a decrease in D-dimer level were found. Fibrinogen level increased to 3.32+/-0.6 g/L significantly in 72 h after radiofrequency ablation (P<0.05). Meanwhile, D-dimer concentration decreased to 0.78+/-0.8 mg/L, but it was still significantly higher (P<0.05) than the baseline value. CONCLUSION: Despite diminished platelet aggregation and increased D-dimer level right after radiofrequency ablation, a risk of thrombosis increased in the next few days after radiofrequency ablation.
Subject(s)
Arrhythmias, Cardiac/surgery , Catheter Ablation , Fibrin Fibrinogen Degradation Products/analysis , Fibrinogen/analysis , Platelet Aggregation , Adult , Aged , Catheter Ablation/adverse effects , Female , Humans , Male , Middle Aged , Postoperative Complications , Risk Factors , Thrombosis/etiology , Time FactorsABSTRACT
OBJECTIVE: To determine the changes in platelet function, manifesting as deviations of their aggregation intensity, in persons with acute ischemic stroke and transient ischemic attacks, to evaluate the effect of aspirin on platelet aggregation, dependent upon degree of cerebral blood flow disturbances and patient's gender, and to compare these changes with those in healthy persons. MATERIAL AND METHODS: We examined 50 patients aged 33 to 98 years (mean age, 63.7+/-2.1 years; 20 men and 30 women) with cerebral blood flow disturbances during acute period (18 with transient ischemic attacks and 32 with ischemic stroke). The diagnosis was confirmed by computer tomography and other clinical examinations. Adenosine diphosphate-, epinephrine-, and collagen-induced platelet aggregation was assessed in platelet-rich plasma. Twelve patients used aspirin at prophylactic doses (100-150 mg/d), and 38 patients did not use. The control group consisted of 25 healthy persons aged 31-64 years (mean age, 45.4+/-1.9 years; 17 men and 8 women). RESULTS: Increased platelet aggregation induced by all three inducers was significantly more frequent in stroke group. Platelet reaction to collagen was more expressed. Aspirin suppressed aggregation, but did not protect against development of ischemic stroke. Higher activity of platelet function during ischemic stroke was observed in platelets from men's plasma. CONCLUSIONS: During acute period, platelet aggregation in platelet-rich plasma statistically significantly increases in the stroke group, independently of the severity of the disease. A part of patients, using recommended dose of prophylactic aspirin, developed ischemic stroke. The effect of aspirin on platelets was more pronounced in women than men.
Subject(s)
Aspirin/therapeutic use , Ischemic Attack, Transient/blood , Ischemic Attack, Transient/prevention & control , Platelet Aggregation Inhibitors/therapeutic use , Platelet Aggregation , Stroke/blood , Stroke/prevention & control , Acute Disease , Adult , Aged , Aged, 80 and over , Aspirin/administration & dosage , Aspirin/pharmacology , Data Interpretation, Statistical , Female , Humans , Ischemic Attack, Transient/diagnostic imaging , Male , Middle Aged , Platelet Aggregation/drug effects , Platelet Aggregation Inhibitors/administration & dosage , Platelet Aggregation Inhibitors/pharmacology , Sex Factors , Stroke/diagnostic imaging , Time Factors , Tomography, X-Ray ComputedABSTRACT
The objective of this article was to find out how radiofrequency catheter ablation (RFA) influences platelet aggregation (PA), and the dependence on the total energy (TE) of RFA used and the cause of arrhythmia. We investigated 97 patients. PA was analyzed before, after, and in 24 hours after RFA. ADP- and epinephrine-induced PA significantly decreased after RFA by 5% and 8.9% (P < .001), respectively, and increased in 24 hours close to baseline. PA induced by ADP and collagen did not radically depend on the TE. Epinephrine-induced PA decreased after RFA by 0%, 8% (P < .05), and 16.9% (P < .01) in groups of patients where the TEs used were <4000 J, 4000 to 15,000 J, and >15,000 J, respectively. There were no significant differences in PA between groups based on the cause of arrhythmia. ADP- and epinephrine-induced PA significantly decreased after RFA and returned close to baseline in 24 hours. Epinephrine-induced PA was inversely associated with the TE used for RFA.
