ArticleJACC. Case reports2025
Severe Hemolysis After Moderate-Dose Pulsed Field Application (48 Pulses) for Atrial Fibrillation/Flutter: A Cautionary Tale.
Article in JACC. Case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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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
2 citing papers in PubMed.
- Evaluation of Hemolysis Risk, Renal Function, and Safety Among Two Pulsed Field Ablation Systems: A Systematic Review and Meta-Analysis.Journal of arrhythmia · 2026Review
- Unexpected acute kidney injury requiring dialysis after routine pulsed field pulmonary vein isolation: a case report.European heart journal. Case reports · 2026Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPulsed field ablation (PFA) has gained popularity for its cardiac selectivity; however, its hemolysis safety profiles are not well understood. CASE SUMMARY: A 69-year-old, African-American man underwent atrial fibrillation/flutter ablation with moderate-dose PFA (48 pulses) and developed significant near-dialysis oliguric acute kidney injury (AKI), requiring a prolonged hospital stay. DISCUSSION: Previous studies have noted an increased risk of hemolysis and AKI with higher PFA lesions, with 70 to 100 pulses being the historical thresholds. This case highlights that hemolysis and AKI could occur with much lower doses than previously considered safe. Universal preventive measures with empirical hydration and extended observation periods post-ablation (overnight stay) could be considered. Genetic factors that could possibly put African Americans at increased risk for hemolysis need to be explored. TAKE-HOME MESSAGES: Hemolysis can occur with any number of pulses with PFA. Pre-existing chronic kidney disease could be a risk factor for developing AKI.
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