Comparative analysis of hemolysis incidence across three different pulsed field ablation systems

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.