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Effects of radiofrequency catheter ablation of atrial fibrillation on soluble P-selectin, von Willebrand factor and IL-6 in the peripheral and cardiac circulation.

Kornej J, Dinov B, Blann AD, Rolf S, Arya A, Schmidl J, Husser D, Hindricks G, Bollmann A, Lip GY - PLoS ONE (2014)

Bottom Line: Plasma markers (von Willebrand factor (vWf), soluble P-selectin (sPsel) and interleukin-6 (IL-6)) were measured by ELISA at three time points in 80 patients (62±10 years, 63% males, 41% paroxysmal AF) undergoing CA.The levels of vWF and IL6--but not sP-sel--increased significantly 24 h after procedure (p<0.001).Baseline vWF was significantly associated with persistent AF (Beta = .303, p = 0.006 and Beta = .300, p = 0.006 for peripheral and cardiac levels, respectively), while persistent AF (Beta = .250, p = 0.031) and LAA flow pattern (Beta = .386, p<0.001) remained associated with vWF in cardiac blood after ablation.

View Article: PubMed Central - PubMed

Affiliation: University of Leipzig, Heart Center, Department of Electrophysiology, Leipzig, Germany; University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom.

ABSTRACT

Background: Catheter ablation (CA) of atrial fibrillation (AF) is associated with inflammatory response, endothelial damage and with increased risk of thrombosis. However, whether these processes differ in peripheral and cardiac circulation is unknown.

Methods: Plasma markers (von Willebrand factor (vWf), soluble P-selectin (sPsel) and interleukin-6 (IL-6)) were measured by ELISA at three time points in 80 patients (62±10 years, 63% males, 41% paroxysmal AF) undergoing CA. These were at baseline--from femoral vein (FV) and left atrium (LA) before ablation; directly after ablation--from the pulmonary vein (PV), LA and FV; and 24 hours after procedure--from a cubital vein (CV).

Results: The levels of vWF and IL6--but not sP-sel--increased significantly 24 h after procedure (p<0.001). Baseline vWF was significantly associated with persistent AF (Beta = .303, p = 0.006 and Beta = .300, p = 0.006 for peripheral and cardiac levels, respectively), while persistent AF (Beta = .250, p = 0.031) and LAA flow pattern (Beta = .386, p<0.001) remained associated with vWF in cardiac blood after ablation. Advanced age was significantly associated with IL6 levels at baseline and after ablation in peripheral and cardiac blood. There were no clinical, procedural or anti-coagulation characteristics associated with sP-sel levels in cardiac blood, while peripheral sP-sel levels were associated with hypertension before (Beta = -.307, p = 0.007) and with persistent AF after ablation (Beta = -.262, p = 0.020).

Conclusions: vWF levels are higher in persistent AF and are associated with LAA rheological pattern after AF ablation. Increase of peripheral vWF and IL6 levels after procedure supports current AF ablation management with careful control of post-procedural anticoagulation to avoid ablation-related thromboembolism.

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Changes in soluble P-selectin levels after catheter ablation.
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pone-0111760-g003: Changes in soluble P-selectin levels after catheter ablation.

Mentions: The levels of vWF and IL6 – but not sP-sel – increased significantly 24 h after procedure (vWFpre 32 [20–61] vs vWFpost 36 [19–55] vs vWFpost_24h 44 [29–87], p<0.001, and IL6pre 1.6 [0.9–2.8] vs IL6post 4.3 [1.9–5.9] vs IL6post_24 h 11.3 [6.0–16.5], p<0.001, Figure 1, Figure 2, Figure 3). Persistent AF (Beta = .250, p = 0.031) and LAA flow velocity (Beta = .386, p<0.001) were associated with vWF in cardiac blood after ablation (Table 5). Similar as with baseline IL6 levels, advanced age was significantly associated with IL6 levels after ablation in both peripheral and cardiac blood (Table 6). In contrast to baseline plasma marker levels, there was significant correlation between vWF and IL6 levels in cardiac blood (r2 = .341, p = 0.002) directly after AF ablation while the correlation in peripheral blood did not reach significance (r2 = .199, p = 0.079).


Effects of radiofrequency catheter ablation of atrial fibrillation on soluble P-selectin, von Willebrand factor and IL-6 in the peripheral and cardiac circulation.

Kornej J, Dinov B, Blann AD, Rolf S, Arya A, Schmidl J, Husser D, Hindricks G, Bollmann A, Lip GY - PLoS ONE (2014)

Changes in soluble P-selectin levels after catheter ablation.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4229097&req=5

pone-0111760-g003: Changes in soluble P-selectin levels after catheter ablation.
Mentions: The levels of vWF and IL6 – but not sP-sel – increased significantly 24 h after procedure (vWFpre 32 [20–61] vs vWFpost 36 [19–55] vs vWFpost_24h 44 [29–87], p<0.001, and IL6pre 1.6 [0.9–2.8] vs IL6post 4.3 [1.9–5.9] vs IL6post_24 h 11.3 [6.0–16.5], p<0.001, Figure 1, Figure 2, Figure 3). Persistent AF (Beta = .250, p = 0.031) and LAA flow velocity (Beta = .386, p<0.001) were associated with vWF in cardiac blood after ablation (Table 5). Similar as with baseline IL6 levels, advanced age was significantly associated with IL6 levels after ablation in both peripheral and cardiac blood (Table 6). In contrast to baseline plasma marker levels, there was significant correlation between vWF and IL6 levels in cardiac blood (r2 = .341, p = 0.002) directly after AF ablation while the correlation in peripheral blood did not reach significance (r2 = .199, p = 0.079).

Bottom Line: Plasma markers (von Willebrand factor (vWf), soluble P-selectin (sPsel) and interleukin-6 (IL-6)) were measured by ELISA at three time points in 80 patients (62±10 years, 63% males, 41% paroxysmal AF) undergoing CA.The levels of vWF and IL6--but not sP-sel--increased significantly 24 h after procedure (p<0.001).Baseline vWF was significantly associated with persistent AF (Beta = .303, p = 0.006 and Beta = .300, p = 0.006 for peripheral and cardiac levels, respectively), while persistent AF (Beta = .250, p = 0.031) and LAA flow pattern (Beta = .386, p<0.001) remained associated with vWF in cardiac blood after ablation.

View Article: PubMed Central - PubMed

Affiliation: University of Leipzig, Heart Center, Department of Electrophysiology, Leipzig, Germany; University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom.

ABSTRACT

Background: Catheter ablation (CA) of atrial fibrillation (AF) is associated with inflammatory response, endothelial damage and with increased risk of thrombosis. However, whether these processes differ in peripheral and cardiac circulation is unknown.

Methods: Plasma markers (von Willebrand factor (vWf), soluble P-selectin (sPsel) and interleukin-6 (IL-6)) were measured by ELISA at three time points in 80 patients (62±10 years, 63% males, 41% paroxysmal AF) undergoing CA. These were at baseline--from femoral vein (FV) and left atrium (LA) before ablation; directly after ablation--from the pulmonary vein (PV), LA and FV; and 24 hours after procedure--from a cubital vein (CV).

Results: The levels of vWF and IL6--but not sP-sel--increased significantly 24 h after procedure (p<0.001). Baseline vWF was significantly associated with persistent AF (Beta = .303, p = 0.006 and Beta = .300, p = 0.006 for peripheral and cardiac levels, respectively), while persistent AF (Beta = .250, p = 0.031) and LAA flow pattern (Beta = .386, p<0.001) remained associated with vWF in cardiac blood after ablation. Advanced age was significantly associated with IL6 levels at baseline and after ablation in peripheral and cardiac blood. There were no clinical, procedural or anti-coagulation characteristics associated with sP-sel levels in cardiac blood, while peripheral sP-sel levels were associated with hypertension before (Beta = -.307, p = 0.007) and with persistent AF after ablation (Beta = -.262, p = 0.020).

Conclusions: vWF levels are higher in persistent AF and are associated with LAA rheological pattern after AF ablation. Increase of peripheral vWF and IL6 levels after procedure supports current AF ablation management with careful control of post-procedural anticoagulation to avoid ablation-related thromboembolism.

Show MeSH
Related in: MedlinePlus