Scholarlink

Background <p>Intravascular hemolysis(IH) is an inherent limitation of pulsed field ablation(PFA) technology. The severity of IH is multifactorial and differs between PFA systems. This study aimed to assess the biochemical evidence and clinical significance of IH induced by a lattice-tip PFA catheter.</p> Methods <p>Patients with atrial fibrillation(AF) undergoing catheter ablation with a lattice-tip PFA catheter or with radiofrequency (RF) (50/90 W) were eligible. Changes in haptoglobin, hemoglobin(Hb), lactate dehydrogenase(LDH), indirect bilirubin, and creatinine were assessed in blood samples collected at baseline (T0), immediately (T1), and 24-h (T2) post-ablation. Clinically relevant IH was defined as changes in biochemical markers of hemolysis in combination with a hemoglobin drop ≥ 2&#xa0;g/dL or renal biomarker changes fulfilling criteria for AKI. Furthermore, in order to properly interpret the observed changes in haptoglobin, “biochemical events” previously associated with direct markers of IH were analyzed [(T2 haptoglobin ≤ 0.25&#xa0;g/l, T2/T0 haptoglobin ratio &lt; 0.85, and T2-T0 haptoglobin difference &lt; Q1 (−0.1&#xa0;g/l)].</p> Results <p>A total of 142 patients [102/142 (72%) in PFA group; 40/142 (28%) in RF group] were included, with comparable characteristics. Significant changes in Hb and LDH were found in both groups. The PFA group experienced a greater decrease in haptoglobin levels compared to RF (MD = −0.02&#xa0;g/L, 95% CI [−0.04, 0]; <i>p</i> = 0.043), while “biochemical events” were infrequent and similar between groups. None of the participants fulfilled the definition of clinically relevant IH. In the PFA group, the number of lesions was marginally associated with greater biomarker changes.</p> Conclusions <p>In this observational real-world cohort, the lattice-tip PFA catheter was associated with statistically significant, yet relatively small reductions of haptoglobin post-procedurally compared to RF, with no case of clinically relevant IH being reported.</p> Graphical abstract <p>In this observational cohort study, patients with atrial fibrillation who underwent catheter ablation either with a lattice-tip PFA catheter or with RF were assessed through consecutive blood samples for biochemical evidence of intravascular hemolysis. Patients in the PFA group experienced a significant decrease in haptoglobin levels that correlated with the number of the delivered PFA lesions. “Biochemical events”&#xa0;related to hemolysis did not differ between groups.</p> <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Biochemical evidence and clinical significance of hemolysis following catheter ablation with a lattice-tip PFA catheter

  • 期刊论文

  • 发表日期：

    2025年10月23日

查看全文
  • Ourania Kariki,
  • Konstantinos Pamporis,
  • Athanasios Saplaouras,
  • Panagiotis Mililis,
  • Theodoros Efremidis,
  • Antonios Martinos,
  • Stavroula Koskina,
  • Anna Kostopoulou,
  • George Poulos,
  • Stylianos Dragasis,
  • Eleni Nikoli,
  • Konstantinos P. Letsas,
  • Michael Efremidis

摘要

Background

Intravascular hemolysis(IH) is an inherent limitation of pulsed field ablation(PFA) technology. The severity of IH is multifactorial and differs between PFA systems. This study aimed to assess the biochemical evidence and clinical significance of IH induced by a lattice-tip PFA catheter.

Methods

Patients with atrial fibrillation(AF) undergoing catheter ablation with a lattice-tip PFA catheter or with radiofrequency (RF) (50/90 W) were eligible. Changes in haptoglobin, hemoglobin(Hb), lactate dehydrogenase(LDH), indirect bilirubin, and creatinine were assessed in blood samples collected at baseline (T0), immediately (T1), and 24-h (T2) post-ablation. Clinically relevant IH was defined as changes in biochemical markers of hemolysis in combination with a hemoglobin drop ≥ 2 g/dL or renal biomarker changes fulfilling criteria for AKI. Furthermore, in order to properly interpret the observed changes in haptoglobin, “biochemical events” previously associated with direct markers of IH were analyzed [(T2 haptoglobin ≤ 0.25 g/l, T2/T0 haptoglobin ratio < 0.85, and T2-T0 haptoglobin difference < Q1 (−0.1 g/l)].

Results

A total of 142 patients [102/142 (72%) in PFA group; 40/142 (28%) in RF group] were included, with comparable characteristics. Significant changes in Hb and LDH were found in both groups. The PFA group experienced a greater decrease in haptoglobin levels compared to RF (MD = −0.02 g/L, 95% CI [−0.04, 0]; p = 0.043), while “biochemical events” were infrequent and similar between groups. None of the participants fulfilled the definition of clinically relevant IH. In the PFA group, the number of lesions was marginally associated with greater biomarker changes.

Conclusions

In this observational real-world cohort, the lattice-tip PFA catheter was associated with statistically significant, yet relatively small reductions of haptoglobin post-procedurally compared to RF, with no case of clinically relevant IH being reported.

Graphical abstract

In this observational cohort study, patients with atrial fibrillation who underwent catheter ablation either with a lattice-tip PFA catheter or with RF were assessed through consecutive blood samples for biochemical evidence of intravascular hemolysis. Patients in the PFA group experienced a significant decrease in haptoglobin levels that correlated with the number of the delivered PFA lesions. “Biochemical events” related to hemolysis did not differ between groups.