SynthesisJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2026
Pulsed field ablation and the risk of hemolysis-driven acute kidney injury: a systematic review and meta-analysis.
Synthesis 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 3 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy and safety of pulsed field ablation and very high-power short-duration ablation for atrial fibrillation: a meta-analysis.Frontiers in cardiovascular medicine · 2026Pooled it
- Evaluation of Hemolysis Risk, Renal Function, and Safety Among Two Pulsed Field Ablation Systems: A Systematic Review and Meta-Analysis.Journal of arrhythmia · 2026Review
- Pulsed-Field Ablation in Adult Congenital Heart Disease: Promise, Prudence, and the Path Forward.JACC. Case reports · 2026Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPulsed-field ablation (PFA) has emerged as a potentially safer alternative to radiofrequency ablation (RFA). However, recent studies have raised concerns that PFA may induce hemolysis, which could contribute to the development of acute kidney injury (AKI).
methodsThe PubMed, Embase, Scopus, and Cochrane databases were searched for randomized clinical trials (RCTs) and non-RCTs that reported AKI incidence and hemolysis biomarkers after PFA. Random-effects models were used to calculate pooled odds ratio (OR) and mean differences (MDs) with 95% confidence intervals (CIs). Substantial heterogeneity was defined as I
resultsTen studies, including one RCT, comprising a total of 3,843 patients, were included, with 1,859 in the PFA group and 1,994 in the RFA group. In the primary endpoint analysis related to AKI and renal function, no significant differences were found between the PFA and RFA groups, with PFA having a total prevalence of 2.1% (95% CI [0.90; 4.84]). The leave-one-out analysis, specifically the exclusion of one outlier study, led to the comparative results having statistical significance statistical significance (OR 3.70, 95% CI [2.49; 5.51], p = 0.0019; I² = 0%), indicating no heterogeneity, and with the total prevalence increasing to 2.4% (95% CI [0.96; 5.93]). Regarding hemolysis, all evaluated biomarkers were significantly elevated in the PFA group, although with high heterogeneity.
conclusionPFA appears to be associated with a slightly higher risk of AKI than RFA. Renal injury is mostly mild-degree and transient. PFA is associated with significant peri-procedural hemolysis.
Indexed as
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.