Measurements of immature platelet fraction (IPF) and inflammatory markers in AF/AFL patients- Does ablation affect results?

Background: Reticulated platelets (RPs) are young platelets with high dense granules content. They are more prothrombotic and hyper-reactive than mature platelets. AF is associated with platelet hyper activity and higher RPs level compared to controls, probably through downregulation of genes that affect platelet biogenesis. AF ablation may impact the expression of these genes. Measuring RPs level by flow cytometry is technically difficult for routine usage. Recently, a simple automated assay was introduced for measuring immature platelet fraction (IPF) using optical fluorescence with good correlation to RPs level. No data exist regarding the effect of ablation on IPF levels. We aimed to examine whether IPF levels and inflammation markers differ before and after ablation of AF or atrial flutter (AFL).

Methods: A prospective study included patients undergoing AF/AFL ablation. We excluded patients with hematologic problem, an acute inflammatory state or acute coronary syndrome. Blood samples for measuring IPF, Neutrophil to Lymphocyte Ratio (NLR) and C-reactive protein (CRP) were collected before ablation, within one-hour post ablation and the day after ablation. IPF was measured by an autoanalyzer (Sysmex 2100 XE, Sysmex America Inc. Mundelein, Illinois).

Results: 45 patients were included in the study (paroxysmal AF=41, Persistent AF=1, AFL=3, age 65±11 y, 60% male, CHAD₂VASC₂ 2.6±1.7). Using ANOVA analysis, there was a significant change in the following parameters the day after ablation compared to baseline and 1-h post ablation values: WBC (baseline 6.7±1.8, 1-h post 7.7±2, and 1-day post 8.7±2.7), % neutrophils (62.4±11, 60.7±13, 69.2±7.7, respectively), NLR (2.9±2.3, 2.99±2.4, 4±2.9, respectively) and CRP (3.58±3.9 mg/dL, 3.4±3.7, 12±9, respectively) (p value

Conclusions: In patients who undergo AF and AFL ablation there is a post ablation inflammatory process, however, thrombogenicity and platelet activation is probably not affected.