Coagulation alterations in treating arrhythmias with radiofrequency ablation

Vilma Kozlovaitė, Pranas Grybauskas, Jūratė Cimbolaitytė, Aušra Mongirdienė, Vytautas Šileikis¹, Vytautas Zabiela¹, Joana Kažanienė², Julius Ptašekas³

Institute of Cardiology, ¹Department of Cardiology, Kaunas University of Medicine, ²Laboratory of Clinical Chemistry and Hematology, Hospital of Kaunas University of Medicine, ³SC “Diagnostic systems,” Vilnius, Lithuania

Key words: platelet aggregation; fibrinogen; D-dimer; radiofrequency ablation.

Summary. 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.

Correspondence to V. Kozlovaitė, Institute of Cardiology, Kaunas University of Medicine, Sukilėlių 17, 50161 Kaunas, Lithuania. E-mail: vkozlovaite@yahoo.com

Received 26 November 2007, accepted 3 September 2009