title: Successful catheter ablation decreases platelet activation and improves endothelial function in patients with atrial fibrillation.
abstract: BACKGROUND
  Nonvalvular atrial fibrillation (AF) confers a five-fold increased risk of stroke. Whether catheter ablation (CA) subsequently decreases prothrombotic risk is unknown.
  
  
  OBJECTIVE
  The purpose of this study was to assess the long-term effects of CA for AF on prothrombotic risk.
  
  
  METHODS
  Fifty-seven patients undergoing CA for AF were prospectively studied. Platelet activation (CD62P [platelet P-selectin] and PAC-1 [glycoprotein IIb/IIIa] expression) and endothelial function (asymmetric dimethylarginine [ADMA] levels) were measured at baseline and 6-months postablation.
  
  
  RESULTS
  Thirty-seven (65%) patients remained in sinus rhythm (SR group) and 20 (35%) sustained AF recurrence (AF recurrence group) at 6-months. Patients with AF-recurrence were older, had a higher proportion of hypertension and long-standing persistent AF. There were no significant differences in CD62P (P = .3), PAC-1 (P = .1) and ADMA (P = .7) levels at baseline between the two groups. In the SR group, markers of platelet activation decreased significantly at 6-month follow-up compared to baseline; log CD62P % 0.79 ± 0.28 vs 1.03 ± 0.27 (P <.05) and log PAC-1 % 0.22 ± 0.58 vs 0.89 ± 0.31 (P <.01). This was not significant in the AF-recurrence group (P = .8, log CD62P; P = .1, log PAC-1). For endothelial function, ADMA levels decreased significantly at 6-months compared to baseline in the SR group (log ADMA μM/L 0.15 ± 0.02 vs 0.17 ± 0.04; P <.05), but did not alter significantly in the AF-recurrence group (P = .4, log ADMA).
  
  
  CONCLUSIONS
  Catheter ablation and successful maintenance of SR leads to a decrease in platelet activation and improvement in endothelial function in patients with AF. These findings suggest that AF is an important determinant of the prothrombotic state and that this may be reduced by successful catheter ablation.
authors: Centre for Heart Rhythm Disorders (CHRD), South Australian Health and Medical Research Institute (SAHMRI), and University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.
authors: Han S
authors: HS
authors: Lim
authors: Centre for Heart Rhythm Disorders (CHRD), South Australian Health and Medical Research Institute (SAHMRI), and University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.
authors: Scott R
authors: SR
authors: Willoughby
authors: Centre for Heart Rhythm Disorders (CHRD), South Australian Health and Medical Research Institute (SAHMRI), and University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.
authors: Carlee
authors: C
authors: Schultz
authors: Centre for Heart Rhythm Disorders (CHRD), South Australian Health and Medical Research Institute (SAHMRI), and University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.
authors: Adhiraj
authors: A
authors: Chakrabarty
authors: Centre for Heart Rhythm Disorders (CHRD), South Australian Health and Medical Research Institute (SAHMRI), and University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.
authors: Muayad
authors: M
authors: Alasady
authors: Centre for Heart Rhythm Disorders (CHRD), South Australian Health and Medical Research Institute (SAHMRI), and University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.
authors: Dennis H
authors: DH
authors: Lau
authors: Centre for Heart Rhythm Disorders (CHRD), South Australian Health and Medical Research Institute (SAHMRI), and University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.
authors: Kurt C
authors: KC
authors: Roberts-Thomson
authors: Centre for Heart Rhythm Disorders (CHRD), South Australian Health and Medical Research Institute (SAHMRI), and University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.
authors: Matthew I
authors: MI
authors: Worthley
authors: Centre for Heart Rhythm Disorders (CHRD), South Australian Health and Medical Research Institute (SAHMRI), and University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.
authors: Glenn D
authors: GD
authors: Young
authors: Centre for Heart Rhythm Disorders (CHRD), South Australian Health and Medical Research Institute (SAHMRI), and University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia. Electronic address: prash.sanders@adelaide.edu.au.
authors: Prashanthan
authors: P
authors: Sanders
mesh_terms: D000368:Aged; D001120:Arginine / Q000031:analogs & derivatives / Q000097:blood; D001281:Atrial Fibrillation / Q000601:surgery*; D015415:Biomarkers / Q000097:blood; D017115:Catheter Ablation / Q000379:methods*; D004562:Electrocardiography; D004730:Endothelium, Vascular / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D039661:Integrin beta3 / Q000097:blood; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood; D015539:Platelet Activation; D011446:Prospective Studies; D012008:Recurrence; D020521:Stroke / Q000209:etiology
chemical_list: D015415:Biomarkers; D039661:Integrin beta3; D019007:P-Selectin; C018524:N,N-dimethylarginine; D001120:Arginine
keywords: Atrial fibrillation; Catheter ablation; Endothelial dysfunction; Platelet activation; Stroke prevention; Thrombotic risk