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Prolonged activation of hemostatic markers following conversion of atrial flutter to sinus rhythm

Kenji Sakurai1, Tadakazu Hirai, Keiko Nakagawa

  • 1The Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University, 2630 Sugutani, Toyama 930-0194, Japan

Circulation Journal : Official Journal of the Japanese Circulation Society
|October 27, 2004
PubMed

Insights

Patients with atrial flutter (AFL) may face a thromboembolism risk after cardioversion. Hemostatic markers indicate a prothrombotic state, suggesting anticoagulation may be needed for selected AFL patients post-cardioversion.

Area of Science:

  • Cardiology
  • Thrombosis Research

Background:

  • The need for anticoagulation in atrial flutter (AFL) patients undergoing cardioversion is debated.
  • This study investigates the prothrombotic state post-cardioversion in AFL.

Purpose of the Study:

  • To assess hemostatic marker concentrations before and after cardioversion of AFL to sinus rhythm (SR).
  • To evaluate the risk of thromboembolism in AFL patients after cardioversion.

Main Methods:

  • Measured plasma concentrations of platelet activity, thrombotic, and fibrinolytic markers in 12 AFL patients.
  • Assessed left atrial appendage (LAA) blood flow velocity and spontaneous echo contrast post-cardioversion.

Main Results:

  • Lower LAA blood flow velocity and spontaneous echo contrast observed immediately after cardioversion.
  • Increased levels of thrombin-antithrombin III complex (TAT) and plasmin-alpha(2)-plasmin inhibitor complex (PIC) 7 days post-cardioversion.

Conclusions:

  • AFL patients exhibit a potential risk for thromboembolism after achieving SR.
  • Anticoagulation therapy may be necessary for specific AFL patients post-cardioversion.
Abstract

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