| Objective:The thrombogenesis as a complication after Radiofrequency catheter ablation(RFCA)is gradually awarded.The previous studies have not fully expounded the mechanism of the complication and were not sure if the RFCA the causation.The D-Dimer and GMP-140 are the most specific molecule symbolizations to reflect the activation of thrombin and platelet and to indicate hypercoagulable state and precoagulable state.so the quantitative examination of DD & GMP-140 in the operation and 2 months later can give chance to observe the coagulable state after RFCA.The study is to discuss the effects on blood coagulable state caused by RFCA via the tests of DD,GMP-140,Protein C and Protein S.Methods:31 patients(13 male,18 female;mean age 42±16y,range 17-71y; 5.3±3.4 lesions produced)with tachycardiac arrhythmia were enrolled in the study. The ablation sites included accessory pathways(n=12,nL=8,nR=4),slow pathways AVNRT(n=15),atricular(n=2)and ventricular foci(n=2,nL=1,nR=1). All the patients denied history of thromboembolism or thrommbosis and hemorrhagic diseases and the test of liver and renal function,blood platelets count,state of clot of blood ranges within normal values,moreover,no patient sumed drugs that affects blood clotting and be supplied aspirin 0.1qd till the third month.The antiarrhythm drugs should be withdrew for more than 5 half periods before operation.The left heart catheter all be used heparin 2000U,but did not the fight ones.Satistics use the way of self-contrast. Venous blood samples were collected at 7 different times to measure the protein C,protein S,plasma platelet alpha-granular membrane glucoprotein and D-dimer by Enzyme-linked Immuno Sorbent Assay(ELISA):before RFCA,immediately after EPS and RFCA,24h,3d,7d,1m(month),2m after RFCA.Results:1.D-dimer(ug/l):After electrophysiologic mapping,the mean D-dimer level increased from baseline value(370±75)to(803±138 P＜0.001)and to a much higher level(1.868±0.897,P＜0.001)after discharging.24-72 hrs after the procedure,the D-dimer level remained at the higher than that before the operation.7 days later the DD level(410±72,P＞0.05)was little higher than that before the operation.After one month the DD level backed to the preoperative level(368±79,P)0.05).2.The plasma levels of GMP-140(ng/ml):After electrophysiologic mapping,the dynamic changing of GMP-140 increased from baseline value(11.984±1.78)to (15.90±1.53,P＜0.005)and to a higher level(21.60±2.11,P＜0.001)after discharging. Different from the change of D-dimer,the concentration of GMP-140 kept increasing to(1480±165,P＜0.001)24h-3d after the operation.7 days later the GMP-140 level (15.20±2.10,P＞0.05)was little higher than that before the operation.After one month the DD level backed to the preoperative level(12.18±1.89,P＞0.05).3.The increase of GMP-140 and DD level had no sequence correlation with the discharge time,X-ray exposure time,total energy and procedure duration(P＞0.05), nor with sex.4.The application of heparin showed no effect on platelet activation at operation but the plasma concentration of D-dimer in heparin group were significantly lower than that in non-heparin group(P＜0.05,P＜0.002 respectively)3-7days after the operation.5.Protein C & S:There is no significant change fore-and-aft the operation.Conclusions:1.The plasma concentration of D-Dimer would be increased during RFCA and last at least 48 hours.2.RFCA can result in an elevation of DD and most of them were transient high or else thromboembolic events would happen.3.There is an elevation of GMP-140 at and after RFCA and last longer than DD.4.EPA and RFCA can cause the activation of platelet and changes the blood coagulable states by increasing the levels of the blood coagulable substances,lead to thronboembolic events.5.The application of heparin can inhibit the elevation of DD after RFCA,but this inhibition can't provide enough protection against thronboembolic state caused by RFCA.A further study is needed to find better drugs on anticoagulation and antiactive platelet to reduce the risk of thrombogenesis.6.No evidence shows EPS & RFCA have any effect on Protein C & S.
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