AI Article Synopsis
- PFA (Pulsed Field Ablation) is being explored as a new treatment for atrial fibrillation but has been linked to cases of acute kidney injury due to haemolysis.
- A study involved 68 patients; about 28% showed significant haemolysis indicated by depleted haptoglobin levels, with higher application numbers correlating to increased risk.
- While acute kidney injury is rare after PFA, it's important to monitor the number of applications to prevent severe haemolysis.
Article Abstract
Aims: Pulsed field ablation (PFA) has been proposed as a novel alternative to radiofrequency (RF) and cryoablation in the treatment of atrial fibrillation (AF). Following the occurrence of two cases of acute kidney injury (AKI) secondary to haemolysis after a PFA procedure, we evaluated haemolysis in a cohort of consecutive patients.
Methods And Results: Two cases of AKI occurred in last May and June 2023. AKI was secondary to acute and severe haemolysis after a PFA procedure. From June 2023, a total of 68 consecutive patients (64.3 ± 10.5 years) undergoing AF ablation with PFA were enrolled in the study. All patients had a blood sample the day after the procedure for the assessment of haemolysis indicators. The pentaspline PFA catheter was used with a total number of median applications of 64 (54; 76). Nineteen patients (28%) showed significantly depleted haptoglobin levels (<0.04 g/L). A significant inverse correlation was found between the plasma level of haptoglobin and the total number of applications. Two groups were compared: the haemolysis+ group (haptoglobin < 0.04 g/L) vs. the haemolysis- group. The total number of applications was significantly higher in the haemolysis+ group vs the haemolysis - group respectively 75 (62; 127) vs 62 (54; 71) P = 0.011. More than 70 applications seem to have better sensitivity and specificity to predict haemolysis.
Conclusion: Intravascular haemolysis can occur after certain procedures of PFA. Acute kidney injury is a phenomenon that appears to be very rare after a PFA procedure. However, caution must be exercised in the number of applications to avoid severe haemolysis.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10776308 | PMC |
| http://dx.doi.org/10.1093/europace/euad371 | DOI Listing |
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