{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T07:05:48Z","timestamp":1784099148650,"version":"3.55.0"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"\n Background<\/jats:title>\n The balloon-in-basket pulsed field ablation (BiB-PFA) system is a novel modality that achieves myocardial-selective ablation with minimal collateral tissue injury. Sex-related differences in biomarker responses following BiB-PFA-guided pulmonary vein isolation (PVI) for atrial fibrillation (AF) remain unclear.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n We aimed to investigate sex-based differences in peri-procedural biomarker responses and procedure-related complications among patients undergoing PVI alone using the BiB-PFA system.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We retrospectively analyzed patients undergoing initial PVI with the BiB-PFA system between January 2024 and March 2026. Peri-procedural inflammatory, myocardial injury, hemolysis, and renal biomarkers were assessed pre-ablation and on the first post-procedural day. Sex-based differences in biomarker changes (\u0394\u2009=\u2009post \u2013 pre) and procedural safety outcomes were compared.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 50 patients were included (50% female). Baseline characteristics and procedural parameters were comparable between groups. \u0394 values in inflammatory markers (\u0394white blood cell count:\n P<\/jats:italic>\n \u2009=\u20090.813; \u0394C-reactive protein:\n P<\/jats:italic>\n \u2009=\u20090.343), myocardial injury markers (\u0394creatine kinase:\n P<\/jats:italic>\n \u2009=\u20090.261; \u0394troponin T:\n P<\/jats:italic>\n \u2009=\u20090.078), hemolysis markers and renal function parameters (\u0394total bilirubin:\n P<\/jats:italic>\n \u2009=\u20090.160; \u0394haptoglobin:\n P<\/jats:italic>\n \u2009=\u20090.104; \u0394estimated glomerular filtration rate:\n P<\/jats:italic>\n \u2009=\u20090.984; \u0394myoglobin:\n P<\/jats:italic>\n \u2009=\u20090.258) did not differ significantly between female and male patients. Procedure-related complications were rare and showed no sex-related differences.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n No statistically significant sex-related differences were detected in peri-procedural biomarker responses or observed procedural complications following BiB-PFA-guided PVI.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1892008","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T06:11:45Z","timestamp":1784095905000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Does sex shape the biological footprint of balloon-in-basket pulsed field ablation\u2013guided pulmonary vein isolation? A biomarker analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Jan-Per","family":"Wenzel","sequence":"first","affiliation":[{"name":"Department of Rhythmology, University of L\u00fcbeck","place":["L\u00fcbeck, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohei","family":"Ukita","sequence":"additional","affiliation":[{"name":"Department of Rhythmology, University of L\u00fcbeck","place":["L\u00fcbeck, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Eitel","sequence":"additional","affiliation":[{"name":"Department of Rhythmology, University of L\u00fcbeck","place":["L\u00fcbeck, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirco","family":"K\u00fcchler","sequence":"additional","affiliation":[{"name":"Department of Rhythmology, University of L\u00fcbeck","place":["L\u00fcbeck, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl-Heinz","family":"Kuck","sequence":"additional","affiliation":[{"name":"Department of Rhythmology, University of L\u00fcbeck","place":["L\u00fcbeck, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sascha","family":"Hatahet","sequence":"additional","affiliation":[{"name":"Department of Rhythmology, University of L\u00fcbeck","place":["L\u00fcbeck, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland Richard","family":"Tilz","sequence":"additional","affiliation":[{"name":"Department of Rhythmology, University of L\u00fcbeck","place":["L\u00fcbeck, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1422","DOI":"10.1161\/CIRCULATIONAHA.123.063988","article-title":"Pulsed field ablation for the treatment of atrial fibrillation: PULSED AF pivotal trial","volume":"147","author":"Verma","year":"2023","journal-title":"Circulation"},{"key":"B2","doi-asserted-by":"publisher","first-page":"euae118","DOI":"10.1093\/europace\/euae118","article-title":"Initial clinical experience with the balloon-in-basket pulsed field ablation system: acute results of the VOLT CE mark feasibility study","volume":"26","author":"Sanders","year":"2024","journal-title":"Europace"},{"key":"B3","doi-asserted-by":"publisher","first-page":"euaf072","DOI":"10.1093\/europace\/euaf072","article-title":"Safety and effectiveness of the first balloon-in-basket pulsed field ablation system for the treatment of atrial fibrillation: VOLT CE mark study 6-month results","volume":"27","author":"Tilz","year":"2025","journal-title":"Europace"},{"key":"B4","doi-asserted-by":"publisher","first-page":"2524","DOI":"10.1016\/j.hrthm.2025.04.037","article-title":"Safety and effectiveness of a novel balloon-in-basket pulsed-field ablation catheter for the treatment of paroxysmal and persistent AF: Volt-AF IDE trial acute results","volume":"22","author":"Lo","year":"2025","journal-title":"Heart Rhythm"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-025-02152-2","article-title":"Catheter design matters: hemolysis and renal function after pulsed field ablation with balloon-in-basket vs. pentaspline systems","author":"Wenzel","year":"2025","journal-title":"J Interv Card Electrophysiol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1861","DOI":"10.1016\/j.hroo.2025.09.003","article-title":"Differential inflammatory and myocardial biomarker response after pulsed field ablation for atrial fibrillation using balloon-in-basket vs pentaspline catheters","volume":"6","author":"Wenzel","year":"2025","journal-title":"Heart Rhythm O2"},{"key":"B7","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1111\/jce.70221","article-title":"Inflammatory and myocardial biomarker response following pulmonary vein isolation: cryoballoon versus balloon-in-basket pulsed field ablation","volume":"37","author":"Wenzel","year":"2026","journal-title":"J Cardiovasc Electrophysiol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1733642","DOI":"10.3389\/fcvm.2026.1733642","article-title":"Biomarker response to balloon-in-basket pulsed field ablation: does posterior wall isolation matter?","volume":"13","author":"Hatahet","year":"2026","journal-title":"Front Cardiovasc Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1016\/j.hroo.2026.01.014","article-title":"How to isolate the superior vena cava using balloon-in-basket pulsed field ablation system: standardized workflow and initial results","volume":"7","author":"Tilz","year":"2026","journal-title":"Heart Rhythm O2"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1024","DOI":"10.4022\/jafib.1024","article-title":"Sex differences in outcomes of ablation of atrial fibrillation","volume":"6","author":"Beck","year":"2014","journal-title":"J Atr Fibrillation"},{"key":"B11","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1093\/ehjqcco\/qcab035","article-title":"Gender differences in complications following catheter ablation of atrial fibrillation","volume":"7","author":"Ngo","year":"2021","journal-title":"Eur Heart J Qual Care Clin Outcomes"},{"key":"B12","doi-asserted-by":"publisher","first-page":"893553","DOI":"10.3389\/fcvm.2022.893553","article-title":"Sex differences in the outcomes of cryoablation for atrial fibrillation","volume":"9","author":"Hermida","year":"2022","journal-title":"Front Cardiovasc Med"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1892008\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T06:11:46Z","timestamp":1784095906000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1892008\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,15]]},"references-count":12,"alternative-id":["10.3389\/fcvm.2026.1892008"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2026.1892008","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,15]]},"article-number":"1892008"}}