Khalid Bin Waleed1, Xiaomeng Yin2, Xiaolei Yang2, Bailing Dai2, Yang Liu2, Zhao Wang2, Xumin Guan2, Lianjun Gao2, De Greef Yves3, Lili Wang4, Gary Tse5, Riccardo Cappato6, Shulin Wu7, Yunlong Xia8. 1. Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China; Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, China. 2. Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China. 3. Electrophysiology Unit, ZNA Middelheim, Antwerp, Belgium. 4. Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, China. 5. Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China; Li Ka Shing Institute of Health Sciences, 30-32 Ngan Shing St, Chinese University of Hong Kong, Hong Kong, China. 6. Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano, Milan, Italy; Humanitas University, Department of Biomedical Sciences, via Rita Levi Montalcini, 420090 Pieve Emanuele, Milan, Italy. 7. Department of Cardiovascular, Atrial Fibrillation Center, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China. 8. Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China. Electronic address: yunlong_xia@126.com.
Abstract
BACKGROUND:Cryoballoon (CB) versus radiofrequency (RF) ablation response on prothrombotic biomarkers obtained different results at short-term, while long-term is still unknown in atrial fibrillation (AF) treatment. We evaluated short and long-term changes in platelet and inflammatory biomarkers after CB and RF ablation. METHODS:Fifty-eight paroxysmal AF patients were randomized for pulmonary vein (PV) isolation using either CB (n = 29) or RF (n = 29) ablation. Biomarkers of platelet activation [P-selectin (CD62P), CD40 ligand (CD40L), platelet factor-4 (PF-4), mean platelet volume (MPV), platelet-leukocyte ratio (P-LCR), and platelet distribution width (PDW)]; and inflammatory [high sensitivity CRP (hs-CRP) and interleukin-6 (IL-6)] were measured at baseline, 18-24 h and 6-Months postablation. RESULTS: Twenty-four (86.2%) and twenty-six (89.7%) patients remained in sinus rhythm at 6-Months in CB and RF group respectively (p = 0.500). After 18-24 h postablation, CD62P, CD40L, PF-4, hs-CRP, and IL-6 levels were significantly activated in both groups (p < 0.001). However, CD62P was significantly lower in CB than RF (p = 0.017). At 6-Month postablation in CB group, all platelet biomarkers CD62P (p = 0.021), CD40L (p < 0.001), PF-4 (p < 0.001), MPV (p = 0.010), PDW (p = 0.004), and P-LCR (p = 0.033) were significantly decreased compared to baseline levels. However in RF group, CD40L and PF-4 (p < 0.001) significant decreased, CD62P (p = 0.022) increased, and no change in MPV and P-LCR (p > 0.05) compared to baseline levels. hs-CRP and IL-6 levels were comparable between baseline and 6-Months in both groups (p > 0.05). CONCLUSIONS:CB ablation might influence the risk of thromboembolism due to less platelet activation after PV isolation and decreased platelet activation at long-term in maintained sinus rhythm patients compared to RF.
RCT Entities:
BACKGROUND: Cryoballoon (CB) versus radiofrequency (RF) ablation response on prothrombotic biomarkers obtained different results at short-term, while long-term is still unknown in atrial fibrillation (AF) treatment. We evaluated short and long-term changes in platelet and inflammatory biomarkers after CB and RF ablation. METHODS: Fifty-eight paroxysmal AFpatients were randomized for pulmonary vein (PV) isolation using either CB (n = 29) or RF (n = 29) ablation. Biomarkers of platelet activation [P-selectin (CD62P), CD40 ligand (CD40L), platelet factor-4 (PF-4), mean platelet volume (MPV), platelet-leukocyte ratio (P-LCR), and platelet distribution width (PDW)]; and inflammatory [high sensitivity CRP (hs-CRP) and interleukin-6 (IL-6)] were measured at baseline, 18-24 h and 6-Months postablation. RESULTS: Twenty-four (86.2%) and twenty-six (89.7%) patients remained in sinus rhythm at 6-Months in CB and RF group respectively (p = 0.500). After 18-24 h postablation, CD62P, CD40L, PF-4, hs-CRP, and IL-6 levels were significantly activated in both groups (p < 0.001). However, CD62P was significantly lower in CB than RF (p = 0.017). At 6-Month postablation in CB group, all platelet biomarkers CD62P (p = 0.021), CD40L (p < 0.001), PF-4 (p < 0.001), MPV (p = 0.010), PDW (p = 0.004), and P-LCR (p = 0.033) were significantly decreased compared to baseline levels. However in RF group, CD40L and PF-4 (p < 0.001) significant decreased, CD62P (p = 0.022) increased, and no change in MPV and P-LCR (p > 0.05) compared to baseline levels. hs-CRP and IL-6 levels were comparable between baseline and 6-Months in both groups (p > 0.05). CONCLUSIONS: CB ablation might influence the risk of thromboembolism due to less platelet activation after PV isolation and decreased platelet activation at long-term in maintained sinus rhythm patients compared to RF.
Authors: Pavel Osmancik; Štěpán Havránek; Veronika Bulková; Jan Chovančík; Tomáš Roubíček; Dalibor Heřman; Zuzana Čarná; Vladimír Tuka; Martin Matoulek; Martin Fiala; Otakar Jiravský; Sylvie Stregl-Hruskova; Adam Latiňák; Jiřina Kotryová; Jiří Jarkovský Journal: BMJ Open Date: 2022-06-15 Impact factor: 3.006
Authors: Lisa W M Leung; Ryan J Imhoff; Howard J Marshall; Diana Frame; Peter J Mallow; Laura Goldstein; Tom Wei; Maria Velleca; Hannah Taylor; Mark M Gallagher Journal: J Cardiovasc Electrophysiol Date: 2021-12-16 Impact factor: 2.942