Cryoablation decreases platelet reactivity in patients with
atrial fibrillation compared with radiofrequency ablation: results from the Sparelife Project

    Authors

    Keywords

    atrial fibrillation, pulmonary vein isolation, platelet reactivity

    DOI

    https://doi.org/10.15836/ccar2017.375

    Full Text

    Introduction : Pulmonary vein isolation (PVI) procedures increase the potential thromboembolic risk ( 1 ). The aim of this study was to compare the effect of radiofrequency (RF) ablation and cryoablation on platelet reactivity (PR) in patients with atrial fibrillation (AF). Patients and Methods : We analyzed PR levels using Multiplate function analyzer in 63 consecutive patients undergoing PVI procedures in our institution. Blood samples were drawn just before the procedure and on the following day. Fourty six (46) and seventeen (17) patients underwent cryoablation and RF ablation, respectively. There was no difference in demographics and baseline platelet parameters (platelet count, MPV and PR) between patients in RF and cryo group. ASPI, ADP and TRAPtest were used to --assess multiple pathways of platelet activation. Results : One day after the procedure mean PR droped from baseline levels in both study groups. The observed delta was more expressed in the cryo group for all three PR tests but only ADPtest showed statistically significant difference in PR ( Figure 1 ). Platelet reactivity before and after pulmonary vein isolation.
RF = radiofrequency Conclusion : Our results show that PR after cryoablation is less pronounced compared to RF procedure. This affirms that thrombogenic burden of PVI is lower with cryoablation. We hypothesize that this could be a result of endocardial integrity preservation and decreased availability of platelet agonists during cryoablation. These results warrant further investigations with periinterventional PR measurements on a larger cohort of patients.

    Cardiologia Croatica
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    Cryoablation decreases platelet reactivity in patients with
atrial fibrillation compared with radiofrequency ablation: results from the Sparelife Project

    Extended Abstract
    Issue9-10
    Published
    Pages375
    PDF via DOIhttps://doi.org/10.15836/ccar2017.375
    atrial fibrillation
    pulmonary vein isolation
    platelet reactivity

    Authors

    Jure Samardžić*ORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Vedran VelagićORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Boško SkorićORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Saša PavasovićORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Marijan PašalićORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Hrvoje JurinORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Ivo PlanincORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Maja ČikešORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Davor PuljevićORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia
    Davor MiličićORCIDUniversity Hospital Centre Zagreb, Zagreb, Croatia

    Full Text

    Introduction : Pulmonary vein isolation (PVI) procedures increase the potential thromboembolic risk ( 1 ). The aim of this study was to compare the effect of radiofrequency (RF) ablation and cryoablation on platelet reactivity (PR) in patients with atrial fibrillation (AF). Patients and Methods : We analyzed PR levels using Multiplate function analyzer in 63 consecutive patients undergoing PVI procedures in our institution. Blood samples were drawn just before the procedure and on the following day. Fourty six (46) and seventeen (17) patients underwent cryoablation and RF ablation, respectively. There was no difference in demographics and baseline platelet parameters (platelet count, MPV and PR) between patients in RF and cryo group. ASPI, ADP and TRAPtest were used to --assess multiple pathways of platelet activation. Results : One day after the procedure mean PR droped from baseline levels in both study groups. The observed delta was more expressed in the cryo group for all three PR tests but only ADPtest showed statistically significant difference in PR ( Figure 1 ). Platelet reactivity before and after pulmonary vein isolation.
RF = radiofrequency Conclusion : Our results show that PR after cryoablation is less pronounced compared to RF procedure. This affirms that thrombogenic burden of PVI is lower with cryoablation. We hypothesize that this could be a result of endocardial integrity preservation and decreased availability of platelet agonists during cryoablation. These results warrant further investigations with periinterventional PR measurements on a larger cohort of patients.