Does pulsed field ablation using a circular array catheter reduce the risk of acute intravascular hemolysis compared to a pentaspline catheter in patients undergoing atrial fibrillation ablation?
Pulsed field ablation for atrial fibrillation causes acute, predominantly mild intravascular hemolysis that correlates with lesion burden and is significantly lower with a circular array catheter compared to a pentaspline catheter.
Background: Procedure-related complications such as intravascular hemolysis have been reported with pulsed field ablation (PFA). However, data for the circular array catheter are limited. Objective: This study aimed to quantify intravascular hemolysis after atrial fibrillation (AF) ablation with the circular array catheter and compare outcomes with alternate PFA systems. Methods: Consecutive patients undergoing AF ablation with PFA at a single center underwent routine postablation bloodwork collection of hemolysis and renal markers. Data were evaluated according to AF ablation strategy (pulmonary vein isolation PVI vs PVI + posterior wall isolation) and between PFA technologies. Predictors of significant hemolysis (plasma free hemoglobin fHb >0.5 g/L]) were assessed using logistic regression. Results: = .056) as predictors of hemolysis. Conclusion: The circular array catheter is associated with mild, lesion number-dependent hemolysis and demonstrates a more favorable hemolytic profile than the pentaspline catheter. Given that haptoglobin and renal parameters take hours to change, we cannot estimate the effects on these parameters or their clinical relevance from an immediate blood draw.
Ranganathan et al. (Thu,) studied this question.
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