High-power short-duration setting prevents changes of periprocedural thrombotic markers and the onset of silent stroke in patients with atrial fibrillation

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart Rhythm O2 Pub Date : 2024-12-01 DOI:10.1016/j.hroo.2024.09.019

Masashi Kamioka MD, Tomonori Watanabe MD, Hiroaki Watanabe MD, Takafumi Okuyama MD, Ayako Yokota MD, Takahiro Komori MD, Tomoyuki Kabutoya MD, Yasushi Imai MD, Kazuomi Kario MD, PhD

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引用次数: 0

Abstract

Background

It remains unclear whether the newly adopted high-power, short-duration (HP-SD) setting in ablation for atrial fibrillation (AF) impacts periprocedural thrombotic markers or silent stroke (SS) onset.

Objective

The aim of the present study was to investigate the clinical impact of HP-SD setting ablation on changes in periprocedural thrombotic markers and the onset of SS.

Methods

We enrolled 101 AF patients: the HP-SD group (n = 67) using 50 W and the conventional ablation group (n = 34) using 30 to 40 W. D-dimer, thrombin-antithrombin complex (TAT), and total plasminogen activator inhibitor-1 (tPAI-1) were analyzed the day before, immediately after, and 1 day after the procedure. Magnetic resonance imaging was performed within 48 hours after the procedure.

Results

Left atrial dwelling time was significantly shorter in the HP-SD group (P < .05). In the conventional ablation group, the D-dimer and tPAI-1 levels continued to increase until 1 day postprocedure, while the TAT peaked immediately after the ablation. On the other hand, the range of the variation of these thrombotic markers in the HP-SD group was smaller. SS occurred more frequently in the conventional ablation group than in the HP-SD group (26% vs 5%, P < .05). In the logistic regression analysis, the HP-SD setting and TAT difference (postprocedure – preprocedure) were independent predictors for SS (odds ratios 0.141 and 5.838, respectively; P < .05).

Conclusions

The HP-SD setting led to a shorter left atrial dwelling time and reduced change in thrombotic markers, resulting in lower prevalence of SS.

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高功率短时间设置可防止心房颤动患者术中血栓标志物的改变和无症状卒中的发生。

背景：目前尚不清楚心房颤动（AF）消融新采用的高功率、短时间（HP-SD）设置是否会影响围手术期血栓标志物或无症状性卒中（SS）发作。目的：本研究的目的是探讨HP-SD设置消融术对围术期血栓形成标志物变化和ss发病的临床影响。方法：我们招募了101例房颤患者：HP-SD组（n = 67）使用50 W，常规消融术组（n = 34）使用30 ~ 40 W。d -二聚体、凝血酶-抗凝血酶复合物（TAT）和总纤溶酶原激活物抑制剂-1 （tPAI-1）在术前、术后和术后1天进行分析。术后48小时内进行磁共振成像。结果：HP-SD组左房停留时间明显缩短（P < 0.05）。在常规消融术组，d -二聚体和tPAI-1水平持续升高至术后1天，而TAT在消融术后立即达到峰值。另一方面，HP-SD组这些血栓标志物的变化范围较小。与HP-SD组相比，常规消融组发生SS的频率更高（26% vs 5%, P . 0.05）。在logistic回归分析中，HP-SD设置和TAT差异（手术后-手术前）是SS的独立预测因子(比值比分别为0.141和5.838；P . 05)。结论：HP-SD设置导致左房停留时间缩短，血栓标志物变化减少，导致SS患病率降低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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