ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2026
Catheter Design Matters: Hemolysis and Renal Function after Pulsed Field Ablation with Balloon-in-Basket vs. Pentaspline Systems.
Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Treatment of paroxysmal and persistent atrial fibrillation with pulsed field ablation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Review
- Physiological Tissue Response to Pulsed-Field Ablation for Atrial Fibrillation: Insights from Biomarker Kinetics.Physiological research · 2026Article
- Early Hemolysis, Myolysis and Renal Stress Following Pentaspline Pulsed Field Versus Radiofrequency Ablation of Atrial Fibrillation.European journal of clinical investigation · 2026Observational
- Pulmonary vein isolation using a novel balloon-in-basket pulsed field ablation system: The Lübeck how-to protocol.Heart rhythm O2 · 2026Article
- Does sex shape the biological footprint of balloon-in-basket pulsed field ablation-guided pulmonary vein isolation? A biomarker analysis.Frontiers in cardiovascular medicine · 2026Article
- Biomarker response to balloon-in-basket pulsed field ablation: does posterior wall isolation matter?Frontiers in cardiovascular medicine · 2026Article
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15 authors.
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Abstract
backgroundPulsed field ablation (PFA) is a non-thermal modality for pulmonary vein isolation (PVI) in atrial fibrillation (AF). While effective, hemolysis and renal effects may occur, potentially modulated by catheter design.
methodsIn this prospective, non-randomized, single-center study, patients underwent PFA-based PVI using either a balloon-in-basket catheter or a pentaspline catheter. Hemolysis (LDH, bilirubin, haptoglobin, myoglobin) and renal markers (creatinine, eGFR) were assessed immediately before and the morning after ablation.
resultsEighty-one patients were included (balloon-in-basket: n=35; pentaspline: n=46), with comparable baseline characteristics. Both groups achieved acute 100% first-pass PVI. The pentaspline group received more PFA applications (32 [32-40] vs. 16 [16-18], p<0.001). Hemolytic markers increased significantly in both groups but were more pronounced in the pentaspline group: LDH Δ+99 [76-121] vs. +59 [43-69] U/L, bilirubin Δ+5.2 [2.4-8.5] vs. +2.4 [0.2-5.1] µmol/L, haptoglobin Δ-28 [-39 to -18] vs. -6 [-17 to +5] mg/dL (all p<0.001). Myoglobin increased modestly in both groups: Δ+12.0 [0-26.0] vs. +11.0 [0-21.5] ng/mL (p=0.696). Only the pentaspline group exhibited a significant renal function decline: creatinine Δ+6.0 [2.2-11.5] vs. +2.0 [-4.0-4.4] µmol/L (p=0.009); eGFR Δ-4.5 [-10.8 to -1.3] vs. -1.0 [-3.5-5.0] mL/min (p=0.002).
conclusionThe pentaspline catheter induced more hemolysis and a measurable decline in renal function. Myoglobin increases were similar in both groups and unlikely to explain the renal findings. Catheter design and energy delivery appear to shape the systemic impact profile of PFA.
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