Intracardiac Fibrinolysis and Endothelium Activation Related to Atrial Fibrillation Ablation with Different Techniques
Objective. The effect of pulmonary vein isolation (PVI) on fibrinolytic and endothelial activation with currently applied periprocedural anticoagulation has not been explored. We measured markers of fibrinolysis and endothelium activation before and after PVI with the second-generation cryoballoon (...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Cardiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2020/1570483 |
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| author | Orsolya Hajas Zsuzsa Bagoly Noémi K Tóth Réka Urbancsek Alexandra Kiss Kitti B Kovács Ferenc Sarkady Attila Nagy Anna V. Oláh László Nagy Marcell Clemens László Csiba Zoltán Csanádi |
| author_facet | Orsolya Hajas Zsuzsa Bagoly Noémi K Tóth Réka Urbancsek Alexandra Kiss Kitti B Kovács Ferenc Sarkady Attila Nagy Anna V. Oláh László Nagy Marcell Clemens László Csiba Zoltán Csanádi |
| author_sort | Orsolya Hajas |
| collection | DOAJ |
| description | Objective. The effect of pulmonary vein isolation (PVI) on fibrinolytic and endothelial activation with currently applied periprocedural anticoagulation has not been explored. We measured markers of fibrinolysis and endothelium activation before and after PVI with the second-generation cryoballoon (Cryo), pulmonary vein ablation catheter (PVAC-Gold), and irrigated radiofrequency (IRF). Methods. Markers of fibrinolysis and endothelium activation in left atrial (LA) blood samples were measured in 31 patients before and after PVI (Cryo:10, PVAC-Gold: 7, IRF: 14). Periprocedural anticoagulation included uninterrupted vitamin K antagonist and iv heparin (ACT≥300 sec) during LA dwelling. Results. Levels of D-dimer (median; interquartile range, mgFEU/L) increased with all techniques (PVAC: 0.34; 0.24–0.50 versus 0.70; 0.61–1.31; p=0.0313, Cryo: 0.33; 0.28–0.49 versus 0.79; 0.65–0.93; p=0.0078; IRF 0.33; 0.21–0.44 versus 0.83; 0.56–1.21; p=0.0001). PAP complex level (ng/ml) increased after Cryo (247.3, 199.9–331.6 versus 270.9, 227.9–346.7; p=0.0020) and IRF (265.3; 202.0–800.1 versus 325.6, 250.2–701.9; p=0.0166), but not after PVAC (p=0.2969). PAI-1 activity (%) decreased with the PVAC (1.931; 0.508–3.859 versus 0.735, 0.240–2.707; p=0.0313) and Cryo (0.361; 0.080–1.575 versus 0.378; 0.111–0.915; p=0.0313). A similar trend was observed with IRF (p=0.0676). Both VWF antigen levels and FVIII activity increased after PVI with all the 3 techniques. The levels of soluble VCAM-1 (ng/ml) did not change after PVAC procedures, but increased after Cryo (542, 6; 428.5–753.1 versus 619.2; 499.8–799.0; p=0.0005) and IRF (679.3; 505.0–744.7 versus 770.9; 631.9–894.0; p<0.0001). Conclusion. PVI with contemporary ablation techniques and periprocedural antithrombotic treatment induces coagulation and endothelium activation of similar magnitude with different ablation methods. |
| format | Article |
| id | doaj-art-c2a99d9b53024e9aa8cceccbc69a9897 |
| institution | Kabale University |
| issn | 2090-8016 2090-0597 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cardiology Research and Practice |
| spelling | doaj-art-c2a99d9b53024e9aa8cceccbc69a98972025-02-03T01:27:04ZengWileyCardiology Research and Practice2090-80162090-05972020-01-01202010.1155/2020/15704831570483Intracardiac Fibrinolysis and Endothelium Activation Related to Atrial Fibrillation Ablation with Different TechniquesOrsolya Hajas0Zsuzsa Bagoly1Noémi K Tóth2Réka Urbancsek3Alexandra Kiss4Kitti B Kovács5Ferenc Sarkady6Attila Nagy7Anna V. Oláh8László Nagy9Marcell Clemens10László Csiba11Zoltán Csanádi12Institute of Cardiology, Faculty of Medicine, University of Debrecen, Debrecen, HungaryDivision of Clinical Laboratory Sciences, Faculty of Medicine, University of Debrecen, Debrecen, HungaryDivision of Clinical Laboratory Sciences, Faculty of Medicine, University of Debrecen, Debrecen, HungaryInstitute of Cardiology, Faculty of Medicine, University of Debrecen, Debrecen, HungaryInstitute of Cardiology, Faculty of Medicine, University of Debrecen, Debrecen, HungaryDepartment of Neurology, Faculty of Medicine, University of Debrecen, Debrecen, HungaryDivision of Clinical Laboratory Sciences, Faculty of Medicine, University of Debrecen, Debrecen, HungaryDepartment of Preventive Medicine, Faculty of Medicine, University of Debrecen, Debrecen, HungaryDivision of Clinical Laboratory Sciences, Faculty of Medicine, University of Debrecen, Debrecen, HungaryInstitute of Cardiology, Faculty of Medicine, University of Debrecen, Debrecen, HungaryInstitute of Cardiology, Faculty of Medicine, University of Debrecen, Debrecen, HungaryMTA-DE Cerebrovascular and Neurodegenerative Research Group, University of Debrecen, Debrecen, HungaryInstitute of Cardiology, Faculty of Medicine, University of Debrecen, Debrecen, HungaryObjective. The effect of pulmonary vein isolation (PVI) on fibrinolytic and endothelial activation with currently applied periprocedural anticoagulation has not been explored. We measured markers of fibrinolysis and endothelium activation before and after PVI with the second-generation cryoballoon (Cryo), pulmonary vein ablation catheter (PVAC-Gold), and irrigated radiofrequency (IRF). Methods. Markers of fibrinolysis and endothelium activation in left atrial (LA) blood samples were measured in 31 patients before and after PVI (Cryo:10, PVAC-Gold: 7, IRF: 14). Periprocedural anticoagulation included uninterrupted vitamin K antagonist and iv heparin (ACT≥300 sec) during LA dwelling. Results. Levels of D-dimer (median; interquartile range, mgFEU/L) increased with all techniques (PVAC: 0.34; 0.24–0.50 versus 0.70; 0.61–1.31; p=0.0313, Cryo: 0.33; 0.28–0.49 versus 0.79; 0.65–0.93; p=0.0078; IRF 0.33; 0.21–0.44 versus 0.83; 0.56–1.21; p=0.0001). PAP complex level (ng/ml) increased after Cryo (247.3, 199.9–331.6 versus 270.9, 227.9–346.7; p=0.0020) and IRF (265.3; 202.0–800.1 versus 325.6, 250.2–701.9; p=0.0166), but not after PVAC (p=0.2969). PAI-1 activity (%) decreased with the PVAC (1.931; 0.508–3.859 versus 0.735, 0.240–2.707; p=0.0313) and Cryo (0.361; 0.080–1.575 versus 0.378; 0.111–0.915; p=0.0313). A similar trend was observed with IRF (p=0.0676). Both VWF antigen levels and FVIII activity increased after PVI with all the 3 techniques. The levels of soluble VCAM-1 (ng/ml) did not change after PVAC procedures, but increased after Cryo (542, 6; 428.5–753.1 versus 619.2; 499.8–799.0; p=0.0005) and IRF (679.3; 505.0–744.7 versus 770.9; 631.9–894.0; p<0.0001). Conclusion. PVI with contemporary ablation techniques and periprocedural antithrombotic treatment induces coagulation and endothelium activation of similar magnitude with different ablation methods.http://dx.doi.org/10.1155/2020/1570483 |
| spellingShingle | Orsolya Hajas Zsuzsa Bagoly Noémi K Tóth Réka Urbancsek Alexandra Kiss Kitti B Kovács Ferenc Sarkady Attila Nagy Anna V. Oláh László Nagy Marcell Clemens László Csiba Zoltán Csanádi Intracardiac Fibrinolysis and Endothelium Activation Related to Atrial Fibrillation Ablation with Different Techniques Cardiology Research and Practice |
| title | Intracardiac Fibrinolysis and Endothelium Activation Related to Atrial Fibrillation Ablation with Different Techniques |
| title_full | Intracardiac Fibrinolysis and Endothelium Activation Related to Atrial Fibrillation Ablation with Different Techniques |
| title_fullStr | Intracardiac Fibrinolysis and Endothelium Activation Related to Atrial Fibrillation Ablation with Different Techniques |
| title_full_unstemmed | Intracardiac Fibrinolysis and Endothelium Activation Related to Atrial Fibrillation Ablation with Different Techniques |
| title_short | Intracardiac Fibrinolysis and Endothelium Activation Related to Atrial Fibrillation Ablation with Different Techniques |
| title_sort | intracardiac fibrinolysis and endothelium activation related to atrial fibrillation ablation with different techniques |
| url | http://dx.doi.org/10.1155/2020/1570483 |
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