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Pulsed Field Ablation-Related Hemolysis: Comparison Between Technologies.

Carola Gianni1, Amin Al-Ahmad1, Mohanad Elchouemi1

  • 1Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, United States (C.G., A.A.-A., M.E., V.M.L.F., S.M., J.D.A., M.A.B., W.D.B., J.D.B., P.C.C., G.J.G., R.P.H., D.J.K., J.E.S., A.N.).

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|December 2, 2025
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Summary
This summary is machine-generated.

Pulsed field ablation (PFA) can cause hemolysis, a side effect that varies by catheter type. The Sphere-9 catheter showed significantly less hemolysis compared to other PFA technologies.

Keywords:
acute kidney injurycatheter ablationhaptoglobinhemoglobinhemolysis

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Area of Science:

  • Cardiology
  • Medical Devices
  • Ablation Technologies

Background:

  • Pulsed field ablation (PFA) is used for atrial fibrillation treatment.
  • Hemolysis is a known complication of PFA, potentially leading to acute kidney injury.
  • Characterizing hemolysis across different PFA technologies is crucial for patient safety.

Purpose of the Study:

  • To compare the degree of hemolysis induced by various PFA catheter technologies.
  • To identify PFA devices associated with lower rates of hemolysis.

Main Methods:

  • Retrospective cohort study of 552 PFA procedures.
  • Haptoglobin (Hp) levels measured at baseline and postoperative day 1.
  • Analysis of hemolysis incidence and severity across Farawave, Sphere-9, Pulseselect, and Varipulse catheters.

Main Results:

  • 95% of procedures showed hemolysis (Hp reduction >10 mg/dL).
  • Sphere-9 catheter demonstrated the lowest incidence (88%) and severity of hemolysis.
  • Farawave and Varipulse catheters showed significantly higher Hp reduction compared to Pulseselect and Sphere-9.

Conclusions:

  • PFA-induced hemolysis is frequent, but the degree varies significantly by catheter technology.
  • The focal PFA catheter Sphere-9 is associated with less hemolysis than single-shot PFA catheters.
  • Choosing appropriate PFA technology can mitigate hemolysis risk and improve patient outcomes.