Pulsed-field ablation significantly reduced haptoglobin levels at 24 hours post-ablation across three systems (all p<0.001), with the greatest hemolysis observed in the FARAPULSE group.
Observational (n=162)
Does pulsed-field ablation using different systems cause varying degrees of hemolysis and myocardial injury compared to radiofrequency ablation in patients with atrial fibrillation?
Different pulsed-field ablation systems induce varying degrees of intravascular hemolysis and myocardial injury, with the severity correlating with the number of applications and lower body mass index.
p-value: p=<0.001
AbstractBackground Pulsed-field ablation (PFA) is associated with a risk of hemolysis; however, the differences among three single-shot PFA systems remain unclear. Objective This study aimed to examine the differences in hemolysis among three PFA systems. Methods We assessed changes in hemolytic, myocardial, and renal biomarkers at baseline and 24-h post-ablation in 131 patients with atrial fibrillation treated with three PFA systems (VARIPULSE, n=26; PulseSelect, n=62; FARAPULSE, n=43), as well as in 23 patients undergoing radiofrequency ablation (RFA; control) and eight patients without ablation (non-ablation control). Results Baseline characteristics were comparable across the groups. Haptoglobin levels decreased from 97.3±52.1 to 49.9±40.1 in the VARIPULSE group, 96.7±41.9 to 53.5±31.2 in the PulseSelect group, and 90.6±43.8 to 27.3±18.6 in the FARAPULSE group (all pConclusions Intravascular hemolysis is a pertinent concern following PFA and is associated with the number of applications and body mass index, with potential differences across the three PFA systems.
Miyazawa et al. (2026) conducted an observational in Atrial fibrillation (n=162). Pulsed-field ablation (VARIPULSE, PulseSelect, FARAPULSE) vs. Radiofrequency ablation and non-ablation control was evaluated on Changes in haptoglobin levels at 24-h post-ablation (p=<0.001). Pulsed-field ablation significantly reduced haptoglobin levels at 24 hours post-ablation across three systems (all p<0.001), with the greatest hemolysis observed in the FARAPULSE group.