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Updated: Apr 26, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Successful catheter ablation decreases platelet activation and improves endothelial function in patients with atrial
Han S Lim1, Scott R Willoughby1, Carlee Schultz1
1Centre for Heart Rhythm Disorders (CHRD), South Australian Health and Medical Research Institute (SAHMRI), and University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.
Insights
Catheter ablation for atrial fibrillation (AF) significantly reduces prothrombotic risk in patients who maintain sinus rhythm. Successful ablation improves platelet activation and endothelial function, suggesting AF contributes to a prothrombotic state.
Area of Science:
- Cardiology
- Vascular Biology
- Interventional Electrophysiology
Background:
- Nonvalvular atrial fibrillation (AF) increases stroke risk five-fold.
- The impact of catheter ablation (CA) on prothrombotic risk in AF patients is not well-established.
Purpose of the Study:
- To evaluate the long-term effects of catheter ablation (CA) on prothrombotic risk in patients with atrial fibrillation (AF).
Main Methods:
- Prospective study of 57 patients undergoing CA for AF.
- Measured platelet activation (CD62P, PAC-1) and endothelial function (ADMA) at baseline and 6 months post-ablation.
Main Results:
- 65% of patients maintained sinus rhythm (SR) post-ablation.
- Successful SR maintenance correlated with decreased platelet activation and improved endothelial function (ADMA levels).
- AF recurrence was associated with older age, hypertension, and persistent AF, with no significant changes in prothrombotic markers.
Conclusions:
- Catheter ablation and sustained sinus rhythm reduce platelet activation and enhance endothelial function in AF patients.
- These findings indicate that AF is a key factor in the prothrombotic state, which can be mitigated by successful CA.
Background:
Nonvalvular atrial fibrillation (AF) confers a five-fold increased risk of stroke. Whether catheter ablation (CA) subsequently decreases prothrombotic risk is unknown.
Objective:
The purpose of this study was to assess the long-term effects of CA for AF on prothrombotic risk.
Methods:
Fifty-seven patients undergoing CA for AF were prospectively studied. Platelet activation (CD62P [platelet P-selectin] and PAC-1 [glycoprotein IIb/IIIa] expression) and endothelial function (asymmetric dimethylarginine [ADMA] levels) were measured at baseline and 6-months postablation.
Results:
Thirty-seven (65%) patients remained in sinus rhythm (SR group) and 20 (35%) sustained AF recurrence (AF recurrence group) at 6-months. Patients with AF-recurrence were older, had a higher proportion of hypertension and long-standing persistent AF. There were no significant differences in CD62P (P = .3), PAC-1 (P = .1) and ADMA (P = .7) levels at baseline between the two groups. In the SR group, markers of platelet activation decreased significantly at 6-month follow-up compared to baseline; log CD62P % 0.79 ± 0.28 vs 1.03 ± 0.27 (P <.05) and log PAC-1 % 0.22 ± 0.58 vs 0.89 ± 0.31 (P <.01). This was not significant in the AF-recurrence group (P = .8, log CD62P; P = .1, log PAC-1). For endothelial function, ADMA levels decreased significantly at 6-months compared to baseline in the SR group (log ADMA μM/L 0.15 ± 0.02 vs 0.17 ± 0.04; P <.05), but did not alter significantly in the AF-recurrence group (P = .4, log ADMA).
Conclusion:
Catheter ablation and successful maintenance of SR leads to a decrease in platelet activation and improvement in endothelial function in patients with AF. These findings suggest that AF is an important determinant of the prothrombotic state and that this may be reduced by successful catheter ablation.
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