Does the paroxysmal period of atrial fibrillation alter fibrino-coagulation parameters compared to the non-paroxysmal period or normal subjects?
There is no significant activation of the fibrino-coagulation system within the first few hours of paroxysmal atrial fibrillation, suggesting thromboembolism may be preventable with early antiarrhythmic therapy.
To clarify the effect of atrial fibrillation (AF) on the fibrino-coagulation system, fibrino-coagulation parameters in the paroxysmal period of AF were determined in 13 patients with paroxysmal atrial fibrillation (PAF) and compared with those in the non-paroxysmal period of AF, and with those in normal subjects. Estimated titers of hemoglobin and hematocrit in the paroxysmal period of AF were significantly higher than those in the non-paroxysmal period and also higher than those in normal subjects. The activated partial thromboplastin time in the paroxysmal period was also longer than that in the non-paroxysmal period of AF or in normal subjects. However, other estimated parameters, such as prothrombin time, fibrinogen, thrombin-antithrombin III, beta-thromboglobulin, platelet factor 4, D-dimer and plasmin inhibitor complex, did not show any significant deviation. These results conflict with those of previous reports which indicated that the fibrino-coagulation system was enhanced in cases of chronic AF. Our results suggest that there is no significant activation of the fibrino-coagulation system, except for obvious hemoconcentration, within the first few hours after the onset of PAF. Thus, in terms of the properties of blood coagulation, thromboembolism is preventable if antiarrhythmic therapy is administered within several hours after the onset of PAF.
Sohara et al. (Sat,) studied this question.