ArticleJournal of cardiovascular electrophysiology2024
Prediction of major intravascular hemolysis during pulsed electric field ablation of atrial fibrillation using a pentaspline catheter.
Article in Journal of cardiovascular electrophysiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pulsed field ablation and the risk of hemolysis-driven acute kidney injury: a systematic review and meta-analysis.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Pooled it
- Intravascular haemolysis following pulsed field ablation pulmonary vein isolation for atrial fibrillation: a systematic review.Open heart · 2025Pooled it
- First-in-human experience and one-year outcomes using a novel conformal pulsed-field ablation balloon catheter for pulmonary vein isolation in paroxysmal atrial fibrillation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Biochemical evidence and clinical significance of hemolysis following catheter ablation with a lattice-tip PFA catheter.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Impact of Pulse Field Ablation on Hemolysis Markers: A Single-Center Experience.Journal of cardiovascular electrophysiology · 2026Article
- Catheter Design Matters: Hemolysis and Renal Function after Pulsed Field Ablation with Balloon-in-Basket vs. Pentaspline Systems.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Delayed coronary vasospasm after pulsed field ablation for pulmonary vein isolation despite avoidance of coronary-adjacent ablation sites.HeartRhythm case reports · 2026Article
- One year outcomes of a fluoroless pulsed field ablation approach for atrial fibrillation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Evaluation of the risk of hemolysis using the circular array pulsed field ablation catheter in the management of atrial fibrillation.Heart rhythm O2 · 2026Article
- Does hemolysis matter after pulsed field ablation for atrial fibrillation? Insights from the Best Ablate Registry.Heart rhythm O2 · 2026Article
- Microbubble Formation and Hemolysis in Pulsed Field Ablation for Treating Arrhythmia: Risks, Mechanisms, and Prevention.Pacing and clinical electrophysiology : PACE · 2026Review
- Differential subclinical hemolysis after pulsed field ablation using the FARAPULSE pentaspline catheter vs the PulseSelect circular multi-electrode array catheter.Heart rhythm O2 · 2025Article
- Effect of pulsed field ablation delivered from noncontact catheter electrodes on hemolysis: A tissue proximity indication-based analysis.Heart rhythm O2 · 2025Article
- Hemolysis Induced by Pulsed-Field Ablation of Atrial Arrhythmias: A Comparative Analysis of Current Systems.Journal of cardiovascular electrophysiology · 2025Article
- Pulse Field Ablation: An Update on Energy-Specific Adverse Events.Reviews in cardiovascular medicine · 2025Review
- Comparative Effects of Pulsed Field and Radiofrequency Ablation on Blood Cell Parameters During Pulmonary Vein Isolation.Biomedicines · 2025Article
- Balloon vs. balloon-comparison of hemolysis and renal markers after cryoballoon vs. ballon-in-basket pulsed field pulmonary vein isolation.Frontiers in cardiovascular medicine · 2025Article
- Complexity and Perplexity of Pulsed Field Ablation: An Engineering Perspective.Arrhythmia & electrophysiology review · 2025Review
- Biophysics and electrophysiology of pulsed field ablation in normal and infarcted porcine cardiac ventricular tissue.Scientific reports · 2024Article
- Prediction of major intravascular hemolysis during pulsed electric field ablation of atrial fibrillation using a pentaspline catheter.Journal of cardiovascular electrophysiology · 2024Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
introductionPulsed electric field (PEF) has emerged as a promising energy source for catheter ablation of atrial fibrillation (AF). However, data regarding the in-vivo effect of PEF energy on erythrocytes during AF ablation procedures are scarce. This study aimed to quantify the impact of PEF energy on erythrocyte damage during AF ablation by assessing specific hemolytic biomarkers.
methodsA total of 60 patients (age: 68 years, males: 72%, serum creatinine: 91 µmol/L) with AF underwent catheter ablation of AF using PEF energy delivered by a multipolar pentaspline Farawave catheter (Farapulse, Boston Scientific, Inc.). Ablation beyond pulmonary vein isolation was performed at the operator's discretion. Peripheral venous blood was sampled for assessing the plasma levels of free hemoglobin (fHb), direct (conjugated) bilirubin, lactate dehydrogenase (LDH), and creatinine before, immediately after the ablation, and on the next day.
resultsFollowing the PEF ablation with duration of [median (interquartile range)] 75 (58, 95) min, with 74 (52, 92) applications and PVI only in 27% of patients, fHb, LDH, and direct bilirubin significantly increased, from 40 (18, 65) to 493 (327, 848) mg/L, from 3.1 (2.6, 3.6) to 6.8 (5.0, 7.9) µkat/L, and from 12 (9, 17) to 28 (16, 44) µmol/L, respectively (all p < .0001). A strong linear correlation was found between the peak fHb and the number of PEF applications (R = 0.81, p < .001). The major hemolysis (defined as fHb >500 mg/L) was predicted by the number of PEF applications with the corresponding area under the receiver operating characteristic curve of 0.934. The optimum cut-off value of >74 PEF applications predicted the major hemolysis with 89% sensitivity and 87% specificity.
conclusionCatheter ablation of AF using PEF energy delivered from a pentaspline catheter is associated with significant intravascular hemolysis. More than 74 PEF applications frequently resulted in major hemolysis. However, the critical amount of PEF energy that may cause kidney injury in susceptible patients remains to be investigated.
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