Abstract 2710: Analysis of the Change in Von Willebrand Factor and ADAMTS13 Concentration Following Radiofrequency Catheter Ablation of Atrial Fibrillation
Background: Atrial fibrillation (AF) has been shown to be associated with endothelial dysfunction. Von Willebrand factor (VWF) are widely accepted as an indicator of endothelial dysfunction. Previous studies have shown raised plasma VWF in subjects with AF compared to controls in sinus rhythm, indicating that VWF might be a plausible marker of increased thrombotic risk in AF. Whereas, a metalloprotease that cleaves VWF multimers has been identified, namely, ADAMTS13. We recently reported that the imbalance between VWF and ADAMTS13 levels caused by atrial remodeling is closely associated with intra-atrial thrombus formation.
Objectives: The purpose of this study was to examine the effect of radiofrequency catheter ablation (RFCA) on the endothelial dysfunction and/or thrombotic risk in AF patients by measuring the change in VWF and ADAMTS13 levels.
Methods and Results: The study subjects consisted of 16 patients (12 men and 4 women; mean age, 61±8 years; range, 47–71 years) with paroxysmal AF who received RFCA. We measured plasma VWF and ADAMTS13 antigen levels before and chronic phase after RFCA. Chronic phase measurement was performed 7.4±4.2 months after RFCA, and sinus rhythm was maintained in all patients at chronic phase. There were no significant differences in the brain natriuretic peptide levels, left atrial diameter and left ventricular ejection fraction measured by transthoracic echocardiography before and chronic phase of RFCA. The plasma VWF antigen levels significantly decreased at chronic phase following RFCA (2067±749, vs. 1554±661 mU/ml, p = 0.0006). Whereas, the plasma ADAMTS13 antigen levels did not differ following RFCA (894±234 vs. 909±233 mU/ml, p = NS). However, the VWF/ADAMTS13 ratio significantly decreased following RFCA (2.54±1.23 vs. 1.87±1.03, p = 0.0015).
Conclusions: These findings suggest that the maintenance of sinus rhythm by RFCA improves the endothelial function. Also, decrease in the VWF/ADAMTS13 ratio may suggest that the improved endothelial function is related to the reduction of the thrombotic events in AF patients.