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.