The Potential of D-dimer Levels as a Useful Clinical Marker of Clotting State after the Return of Sinus Rhythm

Fibrin D-dimers levels have been advocated as a useful clinical marker of thrombogenesis. It is accepted that patients with atrial fibrillation (AF) are characterized by increased levels of plasmatic d-dimers. AF is a high risk factor for hypercoagulability, with a substantial risk of thromboembolism. The most effective way of minimizing the increased thromboembolic risk and treating patients' symptoms is to return the heart rhythm to sinus rhythm by electrical or chemical cardioversion. However, cardioversion of AF itself leads to a further increased risk of thromboembolism. A marker of coagulation activation would be useful to identify patients at the highest thromboembolic risk after cardioversion in AF patients. Indicators of hypercoagulability, such as d-dimers, appear to be a useful parameter for assessing the degree of hypercoagulability of AF patients after cardioversion. Mean changes in plasma d-dimers levels could be used as a useful clinical marker of the clotting state after the return of atrial systole.