Key result
Pulsed field ablation is linked to intravascular hemolysis, highlighting the need for cross-platform evaluation.
Why the study?
The mechanisms, determinants, and clinical relevance of pulsed field ablation-related hemolysis remain incompletely understood despite its recognition as an adverse effect.
PFA-related hemolysis warrants clinical vigilance for AKI; leaves open mechanisms and determinants of progression.
Pulsed field ablation (PFA) has emerged as a transformative technology for cardiac ablation due to its efficiency and favorable safety profile. However, intravascular hemolysis has been increasingly recognized adverse effect across preclinical and clinical studies, infrequently progressing to acute kidney injury (AKI). The mechanisms, determinants, and clinical relevance of PFA-related hemolysis remain incompletely understood. Herein, we review the pathophysiology of PFA-related hemolysis and measures to mitigate its occurrence, discuss the biomarker-related changes and perform a comprehensive review of preclinical hemolysis models. Continued development of physiological benchtop models including numerical models to better understand PFA-related hemolysis and translation to bedside is needed. Furthermore, transparent cross-platform evaluation of hemolysis will be critical in the light of rapidly evolving PFA technologies.
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Mehta et al. (2026) conducted a review in Pulsed field ablation-related hemolysis. Pulsed field ablation (PFA) was evaluated. Pulsed field ablation is associated with intravascular hemolysis, highlighting the need for physiological benchtop models and transparent cross-platform evaluation to understand and mitigate this risk.
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