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Comparative Study
. 2019 May 8;68(2):137-146.
doi: 10.1538/expanim.18-0100. Epub 2018 Oct 31.

Comparison between blood coagulability in the intra-atrial and peripheral regions during the acute phase after rapid atrial pacing

Shusaku Yamada  1 , Daiki Hirao  1 , Naoki Miura  2 , Tomoko Iwanaga  2 , Takae Kawaguchi  1 , Aritada Yoshimura  1 , Takahiro Oomori  1 , Tomoka Nagasato  3 , Ikuro Maruyama  3 , Ryuji Fukushima  1
Affiliations
Comparative Study

Comparison between blood coagulability in the intra-atrial and peripheral regions during the acute phase after rapid atrial pacing

Shusaku Yamada et al. Exp Anim. .

Abstract

The changes in intra-atrial blood coagulability of acute phase after development of atrial fibrillation (AF) have not been elucidated in human. In the present study, blood coagulability were examined in the intra-atrial and peripheral regions during the acute phase after development of rapid atrial pacing (RAP) in experimentally created model dog similar to AF, using Total Thrombus-formation Analysis System (T-TAS) that is capable of comprehensively evaluating thrombogenicity in the bloodstream in the microvascular channel. According to the results, both the coagulating function-evaluating time to +10 kPa (T10) and occlusion time (OT) of the AR chip (chip for thrombus analysis mixed with coagulation and platelet) were significantly shortened in the atrial blood as early as 30 min after pacing (T10, 150.5 ± 40.5 s; OT, 212.4 ± 44.3 s) compared to the pre-pacing levels (T10, 194.5 ± 47.5 s; OT, 259.9 ± 49.5 s) (P<0.05). The OT of PL chip (chip for platelet thrombus analysis) was significantly shortened 30 min after pacing (231.8 ± 57.6 s), compared to the pre-pacing level (289.5 ± 96.0 s) (P<0.05). Meanwhile, none of T10 and OT of AR and PL chips showed any significant changes in the peripheral blood. The study demonstrated increase of blood coagulability 30 min after development of RAP. While no significant changes were observed in the peripheral blood in the present study, the outcome suggested that the anti-thrombus treatments are better to be started early after AF even if coagulability of the peripheral blood shows no change.

Keywords: atrial fibrillation; dog; rapid atrial pacing; thrombogenicity; total thrombus-formation analysis system.

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Conflict of interest statement

This study was supported by the MEXT/JSPS KAKENHI (grant no. 26450425).

Figures

Fig. 1.
Fig. 1.
Electrocardiogram during rapid atrial pacing (2 mV, 390 bpm). In the electrocardiogram, it was confirmed that the disappearance of P wave, absolute irregularity of R-R. The model can reproduce the state similar to AF by rapid atrial pacing.
Fig. 2.
Fig. 2.
Schematic diagram of T-TAS (PL chip). The PL chip was coated with collagen (a). By flowing hirudin-treated whole blood into the PL chip, platelets adhered inside the chip and agglutinated. The pressure inside the chip increased owing to the occlusion of the flow channel by the formation of platelet-specific thrombus (b).
Fig. 3.
Fig. 3.
Figure of pressure rise curve (one example of PL with atrial blood as a sample). In the PL chip of the T-TAS, clogging start time (T10, the time required to reach internal pressure +10 kPa from the baseline) and occlusion time (OT, the time required to reach +60 kPa from the baseline of the PL chip) were measured, and the area under the flow pressure curve (AUC) of the pressure increase was calculated. In this figure, T10 is expressed as 148 s and OT as 202 s. Compared with Pre, it can be seen that OT is shortened to 30 min.
Fig. 4.
Fig. 4.
Occlusion time of the PL chip for the atrial blood in the Pacing and Control groups. Occlusion time of the PL chip for the atrial blood in the Pacing group significantly shortened at 30 min after rapid atrial pacing compared to the pre-rapid atrial pacing level (*compared with the pre-rapid atrial pacing level, a significant difference in P<0.05). No significant changes were observed in the Control group. Pacing group (Pacing): Group with rapid atrial pacing of 390 bpm, 2 mV, n=8. Control group (Control): Group with non-rapid atrial pacing, n=8. Pre: pre-rapid atrial pacing, 30 min: 30 min after rapid atrial pacing. Measurement values are expressed as mean ± SD.
Fig. 5.
Fig. 5.
Occlusion time of the AR chip for atrial blood in the Pacing and Control groups. Occlusion time of the AR chip for the atrial blood in the Pacing group significantly shortened at 30 min after stimulation compared to the pre-rapid atrial pacing level (*compared with the pre-rapid atrial pacing level, a significant difference in P<0.05). No significant changes were observed in the Control group. Pacing group (Pacing): Group with rapid atrial pacing of 390 bpm, 2 mV, n=8. Control group (Control): Group with non-rapid atrial pacing, n=8. Pre: pre-rapid atrial pacing, 30 min: 30 min after rapid atrial pacing. Pre: pre-rapid atrial pacing, 30 min: 30 min after rapid atrial pacing. Measurement values are expressed as mean ± SD.
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