Key result
Ablation for atrial fibrillation significantly increased inflammatory markers like CRP (3.6 to 12.4 mg/L, P<0.05) but did not affect immature platelet fraction (4.6% to 4.9%, P=NS).
Why the study?
AF is linked to platelet hyperactivity and higher immature platelets, but whether immature platelet fraction and inflammatory markers differ by AF type or change after ablation was unclear.
Does ablation or AF persistency affect immature platelet fraction and inflammatory markers in patients with atrial fibrillation?
Observational (n=104)
Does ablation or AF persistency affect immature platelet fraction and inflammatory markers in patients with atrial fibrillation?
Absolute Event Rate: 4.9% vs 4.6%
p-value: p=NS
Cryoablation for atrial fibrillation induces an acute inflammatory response but does not significantly affect platelet activation as measured by immature platelet fraction.
Acute post-ablation inflammation occurs without platelet activation; hypothesis-generating for mechanisms of AF recurrence.
Purpose Atrial fibrillation (AF) is associated with platelet hyperactivity and a higher proportion of immature platelets. We aimed to examine whether immature platelet fraction (IPF) and inflammatory markers differ between AF types and whether they are affected by ablation. Methods A prospective study included patients with atrial fibrillation/flutter (AFL). We excluded patients with hematologic, inflammatory, or acute coronary states. Blood samples for IPF, white blood cells (WBC), neutrophil‐to‐lymphocyte ratio (NLR), and C‐reactive protein (CRP) were collected at baseline, within one‐hour postablation in those undergoing ablations, and the day after ablation. IPF was measured by an autoanalyzer (Sysmex 2100 XE). Results One hundred and four patients were included (paroxysmal AF‐63, persistent AF‐36, AF and AFL‐7, AFL alone‐5), (Mean age 67.7 ± 12.8 years, 54.8% male, CHA 2 D 2 ‐VASC 2 3.2 ± 1.8). Seventy‐two patients underwent ablation (cryoballoon AF ablation‐60, AFL radiofrequency ablation‐5, both‐7). There was no difference between paroxysmal and persistent AF regarding baseline markers. There was a significant change in the following parameters after ablation: WBC (baseline 6.9 ± 2.0, 1‐h post 8.0 ± 2.4, and 1‐day post 9.0 ± 2.8 ×10 9 /L), NLR (2.9 ± 2.2, 3.0 ± 2.4, 4.2 ± 2.9, respectively), and CRP (3.6 ± 3.7, 3.6 ± 3.5, 12.4 ± 9.0 mg/L, respectively) ( P < .05 for all). However, there were no differences in immature platelet count (8.6 ± 4.8, 8.5 ± 4.9, 8.4 ± 5.2 ×10 9 /L) or IPF (4.6 ± 3.2, 4.7 ± 3.3, 4.9 ± 3.6%) from baseline to postablation (p = NS). Conclusions AF persistency does not affect IPF and inflammation. In patients undergoing cryoablation of AF, there is a postablation inflammatory process; however, platelet activation is probably not affected.
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Brezinov et al. (2020) conducted an observational in Atrial fibrillation/flutter (n=104). Ablation vs. Baseline was evaluated on Change in immature platelet fraction (IPF) from baseline to 1-day postablation (p=NS). Ablation for atrial fibrillation significantly increased inflammatory markers like CRP (3.6 to 12.4 mg/L, P<0.05) but did not affect immature platelet fraction (4.6% to 4.9%, P=NS).
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