Fehmi Keçe

Coagulation Markers and Micro-Embolic Signals 117 5 5.1 Introduction In the prospective randomized CE-AF trial from our centre 8 (23%) of the patients undergoing ablation with the non-irrigated PVAC-Gold catheter showed multiple cerebral infarcts (1). In addition, a high median number of micro-embolic signals (MES) on transcranial Doppler ultrasound was detected with this catheter (1111 [interquartile range, 715-2234]. Moreover, during the PVAC-Gold applications, a high incidence of so-called embolic showers was observed. MES represent microbubbles and microparticles within the blood flow (2). We hypothesised that activation of the coagulation cascade may play a role in the genesis of the micro-embolism observed with the PVAC-Gold catheter and studied the relationship between MES and activation of coagulation with this catheter.