title: Radiofrequency catheter ablation of atrial flutter induces the release of platelet and leukocyte-derived procoagulant microparticles and a prothrombotic state.
abstract: BACKGROUND
  To assess the extent of endothelium, platelet, and leukocyte damage and coagulation activation induced by radiofrequency catheter ablation (RF) of atrial flutter. In the vasculature, procoagulant microparticles (MPs) are reliable markers of vascular damage. They provide an additional phospholipidic surface, enabling the assembly of the enzyme complexes of blood coagulation and consequent thrombin generation.
  
  
  METHODS
  MPs were measured in the venous blood of 33 patients with isthmus-dependent atrial flutter undergoing RF before (RF(0)), immediately after (RF(1)), and at day 1 (RF(2)) thereafter. Concentrations of PAI-1, vWF, and D-dimers were simultaneously determined. MPs procoagulant activities were determined using a functional prothrombinase assay. RF induces an early rise of platelet-derived MPs (platelet), vWF Ag, and D-dimers levels, which is concomitant with the decrease of PAI-1 concentrations. Conversely, no significant changes in endothelial-derived MPs could be evidenced. At RF(2), sustained elevation of leukocytes-derived MPs, vWF, and D-dimers testified to an ongoing prothrombotic status.
  
  
  CONCLUSIONS
  RF ablation of common flutter induces a prothrombotic state and the release of platelet and leukocyte-derived procoagulant microparticles. Whereas this activation of blood coagulation could be viewed as clinically marginal in right-sided procedures, its relevance in left-sided procedures should be established.
authors.affiliation: Pôle d'activité médico-chirurgicale cardio-vasculaire des Hôpitaux Universitaires de Strasbourg, Strasbourg Cedex, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Jesel
authors.forename: Olivier
authors.initials: O
authors.lastname: Morel
authors.forename: Sophie
authors.initials: S
authors.lastname: Pynn
authors.forename: Bogdan
authors.initials: B
authors.lastname: Radulescu
authors.forename: Lelia
authors.initials: L
authors.lastname: Grunebaum
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Freyssinet
authors.forename: Patrick
authors.initials: P
authors.lastname: Ohlmann
authors.forename: Pierrre
authors.initials: P
authors.lastname: Bareiss
authors.forename: Florence
authors.initials: F
authors.lastname: Toti
authors.forename: Michel
authors.initials: M
authors.lastname: Chauvin
mesh_terms: D000368:Aged; D001282:Atrial Flutter / Q000276:immunology* / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007962:Leukocytes / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D015539:Platelet Activation / Q000276:immunology*; D013927:Thrombosis / Q000209:etiology* / Q000276:immunology*