Evidence map›Paper›PMID 41328578›Full record

ArticleCirculation. Arrhythmia and electrophysiology2025

Pulsed Field Ablation-Related Hemolysis: Comparison Between Technologies.

Carola Gianni, Amin Al-Ahmad, Mohanad Elchouemi, Vincenzo Mirco La Fazia, Sanghamitra Mohanty, John D Allison, Mohamed A Bassiouny, Weeranun D Bode, J David Burkhardt, Paul C Coffeen and 5 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
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Article in Circulation. Arrhythmia and electrophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
  4. Haemolysis and renal effects across pulsed field ablation systems in atrial fibrillation.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 · 2026
    Article
  5. Influence of dielectric perfusate on pulsed-field ablation-induced haemolysis.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 · 2026
    Article
  6. Review
  7. Review
  8. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Carola GianniTexas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, United States (C.G., A.A.-A., M.E., V.M.L.F., S.M., J.D.A., M.A.B., W.D.B., J.D.B., P.C.C., G.J.G., R.P.H., D.J.K., J.E.S., A.N.).ORCID 0000-0002-8174-7207
Amin Al-AhmadTexas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, United States (C.G., A.A.-A., M.E., V.M.L.F., S.M., J.D.A., M.A.B., W.D.B., J.D.B., P.C.C., G.J.G., R.P.H., D.J.K., J.E.S., A.N.).ORCID 0000-0002-8547-025X
Mohanad ElchouemiTexas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, United States (C.G., A.A.-A., M.E., V.M.L.F., S.M., J.D.A., M.A.B., W.D.B., J.D.B., P.C.C., G.J.G., R.P.H., D.J.K., J.E.S., A.N.).ORCID 0009-0005-2552-5983
Vincenzo Mirco La FaziaTexas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, United States (C.G., A.A.-A., M.E., V.M.L.F., S.M., J.D.A., M.A.B., W.D.B., J.D.B., P.C.C., G.J.G., R.P.H., D.J.K., J.E.S., A.N.).ORCID 0000-0001-7548-4685
Sanghamitra MohantyTexas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, United States (C.G., A.A.-A., M.E., V.M.L.F., S.M., J.D.A., M.A.B., W.D.B., J.D.B., P.C.C., G.J.G., R.P.H., D.J.K., J.E.S., A.N.).ORCID 0000-0001-6601-944X
John D AllisonTexas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, United States (C.G., A.A.-A., M.E., V.M.L.F., S.M., J.D.A., M.A.B., W.D.B., J.D.B., P.C.C., G.J.G., R.P.H., D.J.K., J.E.S., A.N.).ORCID 0000-0002-5172-7627
Mohamed A BassiounyTexas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, United States (C.G., A.A.-A., M.E., V.M.L.F., S.M., J.D.A., M.A.B., W.D.B., J.D.B., P.C.C., G.J.G., R.P.H., D.J.K., J.E.S., A.N.).ORCID 0000-0003-4924-7066
Weeranun D BodeTexas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, United States (C.G., A.A.-A., M.E., V.M.L.F., S.M., J.D.A., M.A.B., W.D.B., J.D.B., P.C.C., G.J.G., R.P.H., D.J.K., J.E.S., A.N.).ORCID 0000-0002-3128-1269
J David BurkhardtTexas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, United States (C.G., A.A.-A., M.E., V.M.L.F., S.M., J.D.A., M.A.B., W.D.B., J.D.B., P.C.C., G.J.G., R.P.H., D.J.K., J.E.S., A.N.).ORCID 0000-0003-1925-5241
Paul C CoffeenTexas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, United States (C.G., A.A.-A., M.E., V.M.L.F., S.M., J.D.A., M.A.B., W.D.B., J.D.B., P.C.C., G.J.G., R.P.H., D.J.K., J.E.S., A.N.).
G Joseph GallinghouseTexas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, United States (C.G., A.A.-A., M.E., V.M.L.F., S.M., J.D.A., M.A.B., W.D.B., J.D.B., P.C.C., G.J.G., R.P.H., D.J.K., J.E.S., A.N.).ORCID 0000-0002-6233-9355
Rodney P HortonTexas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, United States (C.G., A.A.-A., M.E., V.M.L.F., S.M., J.D.A., M.A.B., W.D.B., J.D.B., P.C.C., G.J.G., R.P.H., D.J.K., J.E.S., A.N.).ORCID 0000-0001-9958-2941
David J KesslerTexas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, United States (C.G., A.A.-A., M.E., V.M.L.F., S.M., J.D.A., M.A.B., W.D.B., J.D.B., P.C.C., G.J.G., R.P.H., D.J.K., J.E.S., A.N.).ORCID 0009-0001-3267-0936
Javier E SanchezTexas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, United States (C.G., A.A.-A., M.E., V.M.L.F., S.M., J.D.A., M.A.B., W.D.B., J.D.B., P.C.C., G.J.G., R.P.H., D.J.K., J.E.S., A.N.).ORCID 0000-0002-4488-9863
Andrea NataleTexas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, United States (C.G., A.A.-A., M.E., V.M.L.F., S.M., J.D.A., M.A.B., W.D.B., J.D.B., P.C.C., G.J.G., R.P.H., D.J.K., J.E.S., A.N.).ORCID 0000-0002-5487-0728

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHemolysis is a recognized side effect of pulsed field ablation (PFA). Severe hemolysis can lead to acute kidney injury, affecting the morbidity of patients undergoing PFA for atrial fibrillation. Here, we aimed to characterize the degree of hemolysis across different PFA technologies.

methodsThis is a retrospective cohort study of 552 PFA procedures performed in our center, where Hp (haptoglobin) was measured both at baseline and on postoperative day 1. The PFA catheters used were Farawave (59%), Sphere-9 (19%), Pulseselect (16%), and Varipulse (5.8%).

resultsHemolysis (ie, reduction in Hp >10 mg/dL) was observed in the majority of cases (95%), with the lowest incidence observed in patients undergoing PFA with Sphere-9 (88%) compared with Farawave (97%), Varipulse (97%), and Pulseselect (100%). Significant and severe hemolysis (ie, Hp-postoperative day 1 ≤25 mg/mL and Hp-postoperative day 1 ≤10 mg/mL) occurred in 34% and 13%, with a different distribution across catheter types: Farawave 46% and 21%, Varipulse 29% and 9.7%, Pulseselect 23% and 1.2%, and Sphere-9 5.5% and 0%. Hp decreased by a mean of 76±40 mg/dL from baseline, with a significantly greater degree of reduction seen with Farawave (94±40 mg/dL) and Varipulse (85±32 mg/dL) compared with Pulseselect (62±25 mg/dL) or Sphere-9 (39±23 mg/dL). There is a linear relationship between Hp reduction and number of PFA applications, with a decrease of Hp per application of 0.47 mg/dL (95% CI, 0.22-0.71 mg/dL) for Farawave, 0.40 mg/dL (95% CI, 0.09-0.73 mg/dL) for Pulseselect, and 0.10 mg/dL (95% CI, 0.02-0.19 mg/dL) for Sphere-9.

conclusionsPFA-induced hemolysis is common, with different PFA technologies exhibiting variable degrees of hemolysis, lower with the focal PFA catheter Sphere-9 when compared with single-shot PFA catheters.

Indexed as

Atrial FibrillationCatheter AblationHemolysisAgedEquipment DesignFemaleHumansMaleMiddle AgedRetrospective StudiesTime FactorsTreatment Outcomeacute kidney injurycatheter ablationhaptoglobinhemoglobinhemolysis

Identifiers

PMID41328578
PMCPMC12711278

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