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Article: Transvenous cryoablation reduces platelet activation during pulmonary vein ablation compared with radiofrequency energy in patients with atrial fibrillation

TitleTransvenous cryoablation reduces platelet activation during pulmonary vein ablation compared with radiofrequency energy in patients with atrial fibrillation
Authors
KeywordsAtrial fibrillation
Catheter ablation
Coagulation
Platelet
Issue Date2005
PublisherWiley-Blackwell Publishing, Inc.. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=1045-3873
Citation
Journal Of Cardiovascular Electrophysiology, 2005, v. 16 n. 10, p. 1064-1070 How to Cite?
AbstractBackground: Radiofrequency (RF) ablation procedures for atrial fibrillation (AF) are associated with potential risks of thromboembolism, which may be minimized by the use of cryoablation that preserves the integrity of endocardium. The objective of this study was to compare the thrombogenic potential of transvenous cryoablation versus RF ablation during pulmonary vein (PV) isolation. Methods and Results: Thirty consecutive patients with paroxysmal AF were randomized to undergo segmental PV isolation procedure using 4-mm tip RF ablation (n = 15) or cryoablation (CryoCor, San Diego, CA, USA) (n = 15). Blood samples were drawn after sheath insertion (baseline), after transseptal puncture, before ablation (after heparin administration), and after isolation of a superior PV. Activation of coagulation was measured with plasma levels of prothrombin fragment 1 + 2 (F1 + 2) and thrombin-antithrombin III complex (TAT), and platelets by plasma level of β-thromboglobulin (β-TG) and flow cytometric enumerating of P-selectin (CD62)-positive platelets. In both groups, the plasma level of β-TG, F1 + 2, and TAT were elevated after sheath insertion. The percentage changes in plasma level of β-TG, F1 + 2, and TAT and CD41/62-positive platelets from baseline after transseptal puncture and before ablation were similar (P > 0.05). However, the percentage changes in CD62-positive platelets from baseline were significantly higher in patients treated with RF ablation (82 ± 20%) than with cryoablation (22 ± 14%, P = 0.02), although their plasma levels of β-TG, F1 + 2, and TAT were not different (P > 0.05). Conclusions: Significant platelet and coagulation activations were observed during PV ablation procedures, and heparin administration only prevented activation of coagulation but not platelets. Persistent platelets activation was observed during RF energy application, but not during cryoablation.
Persistent Identifierhttp://hdl.handle.net/10722/77213
ISSN
2015 Impact Factor: 3.097
2015 SCImago Journal Rankings: 1.863
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTse, HFen_HK
dc.contributor.authorKwong, YLen_HK
dc.contributor.authorLau, CPen_HK
dc.date.accessioned2010-09-06T07:29:29Z-
dc.date.available2010-09-06T07:29:29Z-
dc.date.issued2005en_HK
dc.identifier.citationJournal Of Cardiovascular Electrophysiology, 2005, v. 16 n. 10, p. 1064-1070en_HK
dc.identifier.issn1045-3873en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77213-
dc.description.abstractBackground: Radiofrequency (RF) ablation procedures for atrial fibrillation (AF) are associated with potential risks of thromboembolism, which may be minimized by the use of cryoablation that preserves the integrity of endocardium. The objective of this study was to compare the thrombogenic potential of transvenous cryoablation versus RF ablation during pulmonary vein (PV) isolation. Methods and Results: Thirty consecutive patients with paroxysmal AF were randomized to undergo segmental PV isolation procedure using 4-mm tip RF ablation (n = 15) or cryoablation (CryoCor, San Diego, CA, USA) (n = 15). Blood samples were drawn after sheath insertion (baseline), after transseptal puncture, before ablation (after heparin administration), and after isolation of a superior PV. Activation of coagulation was measured with plasma levels of prothrombin fragment 1 + 2 (F1 + 2) and thrombin-antithrombin III complex (TAT), and platelets by plasma level of β-thromboglobulin (β-TG) and flow cytometric enumerating of P-selectin (CD62)-positive platelets. In both groups, the plasma level of β-TG, F1 + 2, and TAT were elevated after sheath insertion. The percentage changes in plasma level of β-TG, F1 + 2, and TAT and CD41/62-positive platelets from baseline after transseptal puncture and before ablation were similar (P > 0.05). However, the percentage changes in CD62-positive platelets from baseline were significantly higher in patients treated with RF ablation (82 ± 20%) than with cryoablation (22 ± 14%, P = 0.02), although their plasma levels of β-TG, F1 + 2, and TAT were not different (P > 0.05). Conclusions: Significant platelet and coagulation activations were observed during PV ablation procedures, and heparin administration only prevented activation of coagulation but not platelets. Persistent platelets activation was observed during RF energy application, but not during cryoablation.en_HK
dc.languageengen_HK
dc.publisherWiley-Blackwell Publishing, Inc.. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=1045-3873en_HK
dc.relation.ispartofJournal of Cardiovascular Electrophysiologyen_HK
dc.subjectAtrial fibrillationen_HK
dc.subjectCatheter ablationen_HK
dc.subjectCoagulationen_HK
dc.subjectPlateleten_HK
dc.titleTransvenous cryoablation reduces platelet activation during pulmonary vein ablation compared with radiofrequency energy in patients with atrial fibrillationen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1045-3873&volume=16&spage=1064&epage=70&date=2005&atitle=Transvenous+cryoablation+reduces+platelet+activation+during+pulmonary+vein+ablation+compared+with+radiofrequency+energy+in+patients+with+atrial+fibrillationen_HK
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_HK
dc.identifier.emailKwong, YL:ylkwong@hku.hken_HK
dc.identifier.authorityTse, HF=rp00428en_HK
dc.identifier.authorityKwong, YL=rp00358en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/j.1540-8167.2005.50103.xen_HK
dc.identifier.scopuseid_2-s2.0-27844573724en_HK
dc.identifier.hkuros113796en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-27844573724&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume16en_HK
dc.identifier.issue10en_HK
dc.identifier.spage1064en_HK
dc.identifier.epage1070en_HK
dc.identifier.isiWOS:000232142200006-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridTse, HF=7006070805en_HK
dc.identifier.scopusauthoridKwong, YL=7102818954en_HK
dc.identifier.scopusauthoridLau, CP=7401968501en_HK
dc.identifier.citeulike333813-

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