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54 Improvement in Endogenous Thrombolytic Status following Successful Ablation of Atrial Fibrillation
  1. Maria Niespialolwska-Steuden1,
  2. Vias Markides2,
  3. Osita Okafor3,
  4. Mohamed Farag3,
  5. Nikolaos Spinthakis3,
  6. Monika Cisecka3,
  7. Diana Adrienne Gorog2,
  8. Peter Collins2
  1. 1Imperial College
  2. 2Imperial College, London
  3. 3East And North Herts NHS Trust

Abstract

Background Atrial fibrillation (AF) is the most frequent sustained cardiac arrhythmia and a major cause of morbidity and mortality. Catheter ablation is a potentially curative treatment. The effect of ablation on global thrombotic status is still uncertain.

Methods A cohort of 34 patients (71% male, aged 63+/-17y) with persistent AF was recruited prior to ablation procedure. The mean CHA2DS2VASC score was 2+/-2 and all the patients were treated with warfarin or novel anticoagulant agents. Global Thrombotic Test (GTT), a point of care blood test measuring markers of thrombogenicity, occlusion time (OT) and lysis time (LT) (in seconds) was utilised. OT reflects platelet reactivity. LT relates to the activity endogenous thrombolysis. As per other studies, increase in OT or shortening of LT has got a potentially prognostic value indicative of reduction in thrombotic risk.

Results At 3 month follow up 20% of patients reversed back to AF. Their OT and LT values remained unchanged in comparison to prior to the ablation: LT med 2005s; IQR [1231;2692] vs. 2848s [2038;3873], P=NS. However 80% of patients remained in SR. Successful elimination of arrhythmia in this group was reflected by reduction in LT (2025s; [1661;2475] vs. 1425s [1060;1893], P = 0.001), but no change in OT. There was a significant difference in LT values between patients who were in SR and those in AF at the time of the follow up (1425s [1060; 1893] vs. 2848 [2038;3873], P = 0.003). Patients anticoagulated with warfarin, had similar INR values at baseline and follow up (2.3+/-0.3).

Conclusion Our study demonstrated that successful ablation of persistent AF improves parameters of thrombogenicity and may potentially improve a long term prognosis. That observation should be confirmed by larger studies.

  • Atrial Fibrillation
  • Thrombosis
  • Ablation

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