Prediction of major intravascular hemolysis during pulsed electric field ablation of atrial fibrillation using a pentaspline catheter

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F24%3A00085273" target="_blank" >RIV/00023001:_____/24:00085273 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216208:11110/24:10488429

Výsledek na webu

<a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/jce.16468" target="_blank" >https://onlinelibrary.wiley.com/doi/epdf/10.1111/jce.16468</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1111/jce.16468" target="_blank" >10.1111/jce.16468</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Prediction of major intravascular hemolysis during pulsed electric field ablation of atrial fibrillation using a pentaspline catheter

Popis výsledku v původním jazyce

Introduction: Pulsed electric field (PEF) has emerged as a promising energy sourcefor catheter ablation of atrial fibrillation (AF). However, data regarding the in‐vivoeffect of PEF energy on erythrocytes during AF ablation procedures are scarce. Thisstudy aimed to quantify the impact of PEF energy on erythrocyte damage during AFablation by assessing specific hemolytic biomarkers.Methods: A total of 60 patients (age: 68 years, males: 72%, serum creatinine:91 µmol/L) with AF underwent catheter ablation of AF using PEF energy deliveredby a multipolar pentaspline Farawave catheter (Farapulse, Boston Scientific, Inc.).Ablation beyond pulmonary vein isolation was performed at the operator&apos;s discre-tion. Peripheral venous blood was sampled for assessing the plasma levels of freehemoglobin (fHb), direct (conjugated) bilirubin, lactate dehydrogenase (LDH), andcreatinine before, immediately after the ablation, and on the next day.Results: Following the PEF ablation with duration of [median (interquartile range)] 75(58, 95) min, with 74 (52, 92) applications and PVI only in 27% of patients, fHb, LDH,and direct bilirubin significantly increased, from 40 (18, 65) to 493 (327, 848) mg/L,from 3.1 (2.6, 3.6) to 6.8 (5.0, 7.9) µkat/L, and from 12 (9, 17) to 28 (16, 44) µmol/L,respectively (all p &lt; .0001). A strong linear correlation was found between the peakfHb and the number of PEF applications (R = 0.81, p &lt; .001). The major hemolysis(defined as fHb &gt;500 mg/L) was predicted by the number of PEF applications withthe corresponding area under the receiver operating characteristic curve of 0.934.The optimum cut‐off value of &gt;74 PEF applications predicted the major hemolysiswith 89% sensitivity and 87% specificity.Conclusion: Catheter ablation of AF using PEF energy delivered from a pentasplinecatheter is associated with significant intravascular hemolysis. More than 74 PEF ap-plications frequently resulted in major hemolysis. However, the critical amount of PEFenergy that may cause kidney injury in susceptible patients remains to be investigated.

Název v anglickém jazyce

Prediction of major intravascular hemolysis during pulsed electric field ablation of atrial fibrillation using a pentaspline catheter

Popis výsledku anglicky

Introduction: Pulsed electric field (PEF) has emerged as a promising energy sourcefor catheter ablation of atrial fibrillation (AF). However, data regarding the in‐vivoeffect of PEF energy on erythrocytes during AF ablation procedures are scarce. Thisstudy aimed to quantify the impact of PEF energy on erythrocyte damage during AFablation by assessing specific hemolytic biomarkers.Methods: A total of 60 patients (age: 68 years, males: 72%, serum creatinine:91 µmol/L) with AF underwent catheter ablation of AF using PEF energy deliveredby a multipolar pentaspline Farawave catheter (Farapulse, Boston Scientific, Inc.).Ablation beyond pulmonary vein isolation was performed at the operator&apos;s discre-tion. Peripheral venous blood was sampled for assessing the plasma levels of freehemoglobin (fHb), direct (conjugated) bilirubin, lactate dehydrogenase (LDH), andcreatinine before, immediately after the ablation, and on the next day.Results: Following the PEF ablation with duration of [median (interquartile range)] 75(58, 95) min, with 74 (52, 92) applications and PVI only in 27% of patients, fHb, LDH,and direct bilirubin significantly increased, from 40 (18, 65) to 493 (327, 848) mg/L,from 3.1 (2.6, 3.6) to 6.8 (5.0, 7.9) µkat/L, and from 12 (9, 17) to 28 (16, 44) µmol/L,respectively (all p &lt; .0001). A strong linear correlation was found between the peakfHb and the number of PEF applications (R = 0.81, p &lt; .001). The major hemolysis(defined as fHb &gt;500 mg/L) was predicted by the number of PEF applications withthe corresponding area under the receiver operating characteristic curve of 0.934.The optimum cut‐off value of &gt;74 PEF applications predicted the major hemolysiswith 89% sensitivity and 87% specificity.Conclusion: Catheter ablation of AF using PEF energy delivered from a pentasplinecatheter is associated with significant intravascular hemolysis. More than 74 PEF ap-plications frequently resulted in major hemolysis. However, the critical amount of PEFenergy that may cause kidney injury in susceptible patients remains to be investigated.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

<a href="/cs/project/LX22NPO5104" target="_blank" >LX22NPO5104: Národní institut pro výzkum metabolických a kardiovaskulárních onemocnění</a><br>

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2024

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Journal of cardiovascular electrophysiology

ISSN

1045-3873

e-ISSN

1540-8167

Svazek periodika

35

Číslo periodika v rámci svazku

12

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

6

Strana od-do

2405-2410

Kód UT WoS článku

001336507100001

EID výsledku v databázi Scopus

2-s2.0-85206211740