Coagulation indicators in patients with paroxysmal atrial fibrillation: effects of electric and pharmacologic cardioversion.

Abstract:

:The aim of this study was to determine whether paroxysmal atrial fibrillation (PAF) and/or restoration to sinus rhythm with electric or pharmacologic cardioversion induce modifications to the coagulation system. Thirty-five patients with PAF undergoing either electric (n = 11) or pharmacologic (n = 24) cardioversion were studied. Fibrinopeptide A and D-dimer blood samples were taken immediately before and after cardioversion at different intervals. When compared with the control group (n = 70), the precardioversion fibrinopeptide A plasma values were significantly elevated (11.8 vs 2.5 ng/mL). Fibrinopeptide A plasma values were significantly reduced 5 minutes after cardioversion (11.8 vs 5.3 ng/mL) and remained stable throughout the follow-up sequential measurements. D-dimer plasma values were significantly increased (measured at 12 hours and at day 7) in patients who underwent electrical cardioversions only. A positive correlation (R(2) = 0.76) was found between the energy delivered for cardioversion to sinus rhythm and D-dimer plasma values on day 7. In patients with PAF, levels of fibrinopeptide A, an indicator of coagulation activation, are elevated and soon reduced by the restoration of sinus rhythm. Electric, but not pharmacologic, cardioversion induces an early activation of the fibrinolytic system.

journal_name

Am Heart J

journal_title

American heart journal

authors

Giansante C,Fiotti N,Miccio M,Altamura N,Salvi R,Guarnieri G

doi

10.1067/mhj.2000.108520

subject

Has Abstract

pub_date

2000-09-01 00:00:00

pages

423-9

issue

3

eissn

0002-8703

issn

1097-6744

pii

S0002-8703(00)42299-4

journal_volume

140

pub_type

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