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Published on: February 26, 2013
Bilirubin Elevation Associated With Pulsed Field Ablation Induced Hemolysis in Patients With Paroxysmal Atrial
Fengqi Xuan1,2, Mingying Ding1, Ming Liang1
1State Key Laboratory of Frigid Zone Cardiovascular Diseases, Cardiovascular Research Institute and Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China.
Background And Aims:
Hemolysis-related renal failure after pulsed field ablation (PFA) has been described in recently published cases, we reported the incidence of bilirubin elevation after PFA utilizing a novel hexaspline PFA catheter.
Methods:
PFA was performed in patients with paroxysmal atrial fibrillation using novel hexaspline PFA catheter, and serum bilirubin, hemoglobin and renal function were measured at baseline and the next day post ablation.
Results:
A total of 94 patients were analyzed, and 30 of 94 (31.9%) patients had obvious total bilirubin elevation the next day post PFA. In the 30 patients, 26 (86.7%) patients had a predominantly indirect hyperbilirubinemia, suggesting a likely presence of PFA-induced hemolysis. The liver enzyme contents post ablation were normal in all patients and no signs of hemolytic anemia and renal function injury were detected. The impact factors associated with indrect hyperbilirubinemia were also analyzed and higher number of applications tented to produce PFA-induced hemolysis. More than 86.5 applications seem to have a better sensivity and specificity to predict hemolysis.
Conclusion:
Intravascular hemolysis can occur after utilizing novel hexaspline catheter, but the severity of hemolysis was mild and temporary. The number of applications appears to be a determining factor leading to hemolysis.
