Patients with atrial fibrillation (AF) are at
increased risk of thrombotic events despite oral anticoagulation
(OAC). Radiofrequency catheter ablation (RFCA) can
restore and maintain sinus rhythm (SR) in patients with AF.
To assess whether RFCA improves thrombotic status. 80
patients (71% male, 64±12y) with recently diagnosed AF,
on OAC and scheduled to undergo RFCA or DC cardioversion
(DCCV) were recruited. Thrombotic status was assessed
using the point-of-care global thrombosis test (GTT), before,
and 4–6 weeks after DCCV and 3 months after RFCA. The
GTT first measures the time taken for occlusive thrombus
formation (occlusion time, OT), while the second phase of
the test measures the time taken to spontaneously dissolve
this clot through endogenous thrombolysis (lysis time, LT).
3 months after RFCA, there was a significant reduction in
LT (1994s [1560; 2475] vs. 1477s [1015; 1878]) in those
who maintained SR, but not in those who reverted to AF. At
follow-up, LT was longer in those in AF compared to those
in SR (AF 2966s [2038; 3879] vs. SR 1477s [1015; 1878]).
RFCA resulted in no change in OT value, irrespective of hythm outcome. Similarly, there was no change in OT or
LT in response to DCCV, irrespective of whether SR was
restored. Successful restoration and maintenance of SR following
RFCA of AF is associated with improved global
thrombotic status with enhanced fibrinolysis. Larger studies
are required to confirm these early results and investigate
whether improved thrombotic status translates into fewer
thromboembolic events.