{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T03:02:30Z","timestamp":1794279750284,"version":"4.9.0"},"reference-count":45,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Pulsed field ablation (PFA) is increasingly used in clinical practice for the treatment of atrial fibrillation. While the susceptibility of erythrocytes to electroporation is well established, the effect of cardiac PFA technologies on hemolysis has remained underreported. The aim of this study was to investigate the incidence, severity, and clinical impact of PFA-induced hemolysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We included n=145 patients undergoing atrial fibrillation catheter ablation with a pentaspline PFA catheter (biphasic, bipolar pulses of 2 kV) and n=70 patients receiving radiofrequency ablation (40\u201390 W) at 4 high-volume European centers. The lesion set comprised pulmonary vein isolation for paroxysmal atrial fibrillation and pulmonary vein isolation\u00b1additional lesions for persistent atrial fibrillation. Hemolysis and renal function biomarkers were analyzed in blood samples at baseline, at the end of ablation, and 24 hours after the procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Baseline characteristics were well balanced between groups (overall mean 65.7\u00b19.4 years; 69.3% men). The ablation procedures comprised a mean of 61.6\u00b127.4 PFA deliveries and 26.3\u00b115.0 minutes RF duration. Hemolysis was detected in 94.3% versus 6.8% of patients after PFA versus radiofrequency ablation (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001): PFA was associated with significantly lower haptoglobin levels (0.5\u00b10.4 versus 1.0\u00b10.4 g\/L), while free plasma hemoglobin (592.8\u00b1330.6 versus 147.8\u00b1183.0 mg\/L), bilirubin (21.3\u00b111.3 versus 14.8\u00b18.8 \u00b5mol\/L), and LDH (lactate dehydrogenase, 352.7\u00b1115.7 versus 253.2\u00b156.5 U\/L) were significantly higher after PFA compared with radiofrequency ablation (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001). Hemolysis correlated with the number of PFA deliveries (r=0.62 [95% CI, 0.33\u20130.80];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001), with the highest severity occurring \u226554 PFA deliveries. After PFA, hemoglobinuria occurred in 36.4%, while creatinine increase was higher in patients with baseline glomerular filtration rate &lt;50 mL\/min than with baseline glomerular filtration rate &gt;50 mL\/min (\u0394crea, 27.0\u00b1103.1 versus \u22120.2\u00b112.1 \u00b5mol\/L;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.010).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Intravascular hemolysis is a frequent finding after PFA and increases with the number of PFA deliveries. Until the clinical impact of PFA-associated hemolysis is fully elucidated, a careful titration of PFA deliveries during the ablation procedure is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circep.124.012732","type":"journal-article","created":{"date-parts":[[2024,8,30]],"date-time":"2024-08-30T05:01:58Z","timestamp":1724994118000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":140,"title":["Characterization and Clinical Significance of Hemolysis After Pulsed Field Ablation for Atrial Fibrillation: Results of a Multicenter Analysis"],"prefix":"10.1161","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9308-2492","authenticated-orcid":true,"given":"Miruna A.","family":"Popa","sequence":"first","affiliation":[{"name":"Department of Cardiac Pacing and Electrophysiology, H\u00f4pital Cardiologique du Haut-L\u00e9v\u00eaque, CHU de Bordeaux (M.A.P., F. Sacher, N.D., M.H., P.J.)."},{"name":"IHU LIRYC, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9 and INSERM\u2014U1045, University of Bordeaux, France (M.A.P., F. Sacher, N.D., M.H., G.C., P.J.)."},{"name":"Department of Electrophysiology, German Heart Centre Munich (M.A.P.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1129-5089","authenticated-orcid":true,"given":"Sandrine","family":"Venier","sequence":"additional","affiliation":[{"name":"University Hospital of Grenoble Alpes (S.V., P.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1671-1977","authenticated-orcid":true,"given":"Roberto","family":"Men\u00e8","sequence":"additional","affiliation":[{"name":"Cardiology-Heart Rhythm Management Department, Clinique Pasteur, Toulouse, France (R.M., S.C., J.-P.A., F. Saitta, S.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3837-3462","authenticated-orcid":true,"given":"Domenico Giovanni","family":"Della Rocca","sequence":"additional","affiliation":[{"name":"Universiteit Ziekenhuis, Vrije Universiteit Brussel (VUB), Jette Brussels, Belgium (D.D.R., G.-B.C., C.d.A., S.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8348-9320","authenticated-orcid":true,"given":"Fr\u00e9d\u00e9ric","family":"Sacher","sequence":"additional","affiliation":[{"name":"Department of Cardiac Pacing and Electrophysiology, H\u00f4pital Cardiologique du Haut-L\u00e9v\u00eaque, CHU de Bordeaux (M.A.P., F. Sacher, N.D., M.H., P.J.)."},{"name":"IHU LIRYC, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Universit\u00e9 and INSERM\u2014U1045, University of Bordeaux, France (M.A.P., F. 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