Periprocedural Intravascular Hemolysis During Atrial Fibrillation Ablation: A Comparison of Pulsed Field With Radiofrequency Ablation
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064173%3A_____%2F24%3A43927129" target="_blank" >RIV/00064173:_____/24:43927129 - isvavai.cz</a>
Alternative codes found
RIV/00216224:14110/24:00136789 RIV/00216208:11120/24:43927129
Result on the web
<a href="https://doi.org/10.1016/j.jacep.2024.05.001" target="_blank" >https://doi.org/10.1016/j.jacep.2024.05.001</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1016/j.jacep.2024.05.001" target="_blank" >10.1016/j.jacep.2024.05.001</a>
Alternative languages
Result language
angličtina
Original language name
Periprocedural Intravascular Hemolysis During Atrial Fibrillation Ablation: A Comparison of Pulsed Field With Radiofrequency Ablation
Original language description
Background Hemolysis-related renal failure has been described after pulmonary vein isolation (PVI) with pulsed-field ablation (PFA). Objectives This study sought to compare the potential for hemolysis during PVI with PFA vs radiofrequency ablation (RFA). Methods In consecutive patients, PVI was performed with PFA or RFA. Blood samples were drawn at baseline, immediately postablation, and 24 hours postablation. Using flow cytometry, the concentration of red blood cell microparticles (RBC mu) (fragments of damaged erythrocytes) in blood was assessed. Lactate dehydrogenase (LDH), haptoglobin, and indirect bilirubin were measured at baseline and 24 hours. Results Seventy patients (age: 64.7 +/- 10.2 years; 47% women; 36 [51.4%] paroxysmal atrial fibrillation) were enrolled: 47 patients were in the PFA group (22 PVI-only and 36.4 +/- 5.5 PFA applications; 25 PVI-plus, 67.3 +/- 12.4 pulsed field energy applications), and 23 patients underwent RFA. Compared to baseline, the RBC mu concentration increased similar to 12-fold postablation and returned to baseline by 24 hours in the PFA group (median: 70.8 [Q1-Q3: 51.8-102.5] vs 846.6 [Q1-Q3: 639.2-1,215.5] vs 59.3 [Q1-Q3: 42.9-86.5] RBC mu/mu L, respectively; P < 0.001); this increase was greater with PVI-plus compared to PVI-only (P = 0.007). There was also a significant, albeit substantially smaller, periprocedural increase in RBC mu with RFA (77.7 [Q1-Q3: 39.2-92.0] vs 149.6 [Q1-Q3: 106.6-180.8] vs 89.0 [Q1-Q3: 61.2-123.4] RBC mu/mu L, respectively; P < 0.001). At 24 hours with PFA, the concentration of LDH and indirect bilirubin increased, whereas haptoglobin decreased significantly (all P < 0.001). In contrast, with RFA, there were only smaller changes in LDH and haptoglobin concentrations (P = 0.03) and no change in bilirubin. Conclusions PFA was associated with significant periprocedural hemolysis. With a number of 70 PFA lesions, the likelihood of significant renal injury is uncommon.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30201 - Cardiac and Cardiovascular systems
Result continuities
Project
<a href="/en/project/LX22NPO5104" target="_blank" >LX22NPO5104: National Institute for Research of Metabolic and Cardiovascular Diseases</a><br>
Continuities
I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace
Others
Publication year
2024
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
JACC: Clinical Electrophysiology
ISSN
2405-500X
e-ISSN
2405-5018
Volume of the periodical
10
Issue of the periodical within the volume
7, Part 2
Country of publishing house
US - UNITED STATES
Number of pages
12
Pages from-to
1660-1671
UT code for WoS article
001282714600001
EID of the result in the Scopus database
2-s2.0-85195404315