Comparison of hemostatic activation created by right- and left-heart radiofrequency catheter ablation.

BACKGROUND

Thromboembolic complications commonly occur in radiofrequency (RF) ablation procedures (0.6-1.3% of cases). Comparison of hemostatic activation between left and right RF ablation is limited.

HYPOTHESIS

The purpose of this study was to evaluate platelet and hemostatic activation before, immediately after, and 48 h following left and right myocardial RF ablation procedures.

METHODS

The subjects were two groups of patients who underwent right-heart (24 patients) and left-heart (20 patients) RF ablation. Blood samples taken before, immediately after, and 48 h after the procedure were tested for changes in platelet and hemostatic activation.

RESULTS

No indication of clinically symptomatic thromboembolism and no major differences in baseline characteristics and procedure were apparent in either group, except for a higher temperature mode setting (p < 0.001) in the left-heart group. The hemostatic evaluation levels increased significantly by the end of the procedure in both groups and the platelet activation level remained elevated for 48 h after the procedure. The platelet activation level increased insignificantly at the end and 48 h after the procedure. Of the other changes in levels of platelet and hemostatic activation, only an increase in one of the hemostatic levels in the right-heart group at 48 h after procedure was significant (p = 0.01).

CONCLUSIONS

Our findings suggest that similar hemostatic activation occurred during and immediately after RF ablation in both groups. Sustained elevation of the hemostatic marker after the ablation procedure in the right-heart group was observed as of significant therapeutic and prognostic implications.