ArticleHeart rhythm O22026
Does hemolysis matter after pulsed field ablation for atrial fibrillation? Insights from the Best Ablate Registry.
Article in Heart rhythm O2, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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
1 citing paper 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
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Pulsed field ablation (PFA) has emerged as a novel nonthermal modality for atrial fibrillation (AF) ablation, offering tissue selectivity and procedural safety. However, emerging data have raised concerns about hemolysis-related biomarker shifts and potential renal failure after PFA. Objective: This study aimed to evaluate biomarker-defined hemolysis and the incidence of acute renal injury after PFA in patients undergoing AF. Methods: In this prospective observational study, 84 patients with paroxysmal or persistent AF undergoing PFA using either the Affera or PulseSelect system were enrolled. Paired venous blood samples were obtained before and 24 hours after the procedure. Biomarkers of hemolysis (lactate dehydrogenase [LDH], haptoglobin, hemoglobin, and bilirubin), renal function parameters (serum creatinine, urea, and electrolytes), and cardiac enzymes (high-sensitivity cardiac troponin, N-terminal pro-B-type natriuretic peptide) were systematically analyzed. Clinically significant hemolysis was defined as a postprocedural haptoglobin concentration of <0.04 g/L or a combination of indirect bilirubin of >1.5 times baseline and LDH more than twice baseline. Multivariable linear regression and mediation analyses were performed to identify procedural predictors of biomarker changes and explore the potential mediating role of myocardial injury. Results: Significant postprocedural changes were observed in biomarkers of hemolysis, including a reduction in haptoglobin (-0.17 ± 0.21 g/L; Conclusion: In our study, PFA for AF was associated with an increase in hemolytic parameters, without significant short-term renal impact or occurrence of clinically significant hemolysis. Hemolysis seems to be influenced by both lesion burden and myocardial injury, highlighting the need for further investigation into the long-term clinical relevance of biomarker-defined hemolysis in PFA-treated patients.
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