5.3 Anticoagulation
Previous studies reported that continuation of anticoagulation in
peri-operative period can reduce ischemic complication after
RFCA.19,
20 However, pre- or post-RFCA
anticoagulation did not affect the incidence of peri-procedural ischemic
complication in our study. Since embolic material formed by catheter
ablation is mainly consisted of denaturized and aggregated proteins
rather than classical thrombus, peri-procedural ischemic complication
can still occur despite optimal anticoagulation
therapy.9 Indeed, heat
induced protein denaturation and aggregation occurred independently from
heparin concentration.9Nevertheless, optimal anticoagulation therapy should be done in
peri-procedural period since denaturized material formed by
radiofrequency energy can activate coagulation cascade. Both irrigation
and anticoagulation are essential.