Delayed thrombogenesis following radiofrequency catheter ablation.
The cause and duration of the thrombogenesis provoked by radiofrequency catheter ablation (RF-CA) was investigated by measuring the thrombin-antithrombin III complex (TAT) in 43 patients who underwent RF-CA and in 20 control subjects who underwent an electrophysiologic study. Blood samples were collected at 7 different times: before introducing the sheaths, during the ablation procedure and at 30 min, 6 and 24h, and 3 and 6 days after the procedure. Hepatocyte growth factor (HGF) was simultaneously measured in the ablation group. Plasma TAT concentration exhibited a double peaked pattern in the ablation group: the first peak occurred during the ablation procedure (42.8+/-15.5 ng/ml), and the second peak 3 days later. Plasma TAT at 3 days after the procedure was significantly higher than that of the control group (21.3+/-19.0 vs 2.5+/-1.4, p=0.0003). The first peak significantly correlated with the procedure time prior to the administration of heparin (r=0.669), but the second peak did not (r=0.132). A subgroup with a serum HGF >0.40 ng/ml at 6 h after the procedure exhibited a significantly high second peak. The thrombogenesis caused by RF-CA has 2 phases; in the acute phase, there is hemostasis during placement of the catheters, and in the delayed phase thrombogenesis is the result of endothelial damage from the RF current.
Cardiovascular Department, Yokohama Red Cross Hospital, Japan. sasa.cvm@tmd.ac.jp
Tetsuo
T
Sasano
Kenzo
K
Hirao
Kei
K
Yano
Mihoko
M
Kawabata
Kaoru
K
Okishige
Mitsuaki
M
Isobe
D000328:Adult; D000704:Analysis of Variance; D017115:Catheter Ablation / Q000009:adverse effects*; D004730:Endothelium, Vascular / Q000473:pathology; D029968:Escherichia coli Proteins / Q000097:blood; D005260:Female; D006487:Hemostasis; D006493:Heparin / Q000008:administration & dosage; D017228:Hepatocyte Growth Factor / Q000097:blood; D006801:Humans; D008297:Male; D026901:Membrane Transport Proteins / Q000097:blood; D008875:Middle Aged; D013927:Thrombosis / Q000097:blood / Q000209:etiology*; D013997:Time Factors
D029968:Escherichia coli Proteins; D026901:Membrane Transport Proteins; C408585:twin-arginine translocase complex, E coli; D017228:Hepatocyte Growth Factor; D006493:Heparin