Evidence map›Paper›PMID 42530033›Full record

ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2026

Haemolysis and renal effects across pulsed field ablation systems in atrial fibrillation.

Matteo Rocchetti, David Schaack, Aldo Marrese, Andrea Urbani, Joseph Kheir, Soroosh Najafi, Melanie Gunawardene, Alexandra Marx, Julia Lurz, Boris Schmidt and 2 more

Abstract read
In one paragraph

Article in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Matteo RocchettiCardioangiologisches Centrum Bethanien, Agaplesion Markus-Krankenhaus, Wilhelm-Epstein-Str. 4, Frankfurt, Germany.ORCID 0009-0007-8844-4042
David SchaackCardioangiologisches Centrum Bethanien, Agaplesion Markus-Krankenhaus, Wilhelm-Epstein-Str. 4, Frankfurt, Germany.ORCID 0000-0003-4188-3447
Aldo MarreseCardioangiologisches Centrum Bethanien, Agaplesion Markus-Krankenhaus, Wilhelm-Epstein-Str. 4, Frankfurt, Germany.ORCID 0009-0002-3373-2833
Andrea UrbaniCardioangiologisches Centrum Bethanien, Agaplesion Markus-Krankenhaus, Wilhelm-Epstein-Str. 4, Frankfurt, Germany.ORCID 0000-0002-8905-0922
Joseph KheirCardioangiologisches Centrum Bethanien, Agaplesion Markus-Krankenhaus, Wilhelm-Epstein-Str. 4, Frankfurt, Germany.ORCID 0009-0003-1538-406X
Soroosh NajafiCardioangiologisches Centrum Bethanien, Agaplesion Markus-Krankenhaus, Wilhelm-Epstein-Str. 4, Frankfurt, Germany.ORCID 0000-0002-0663-7083
Melanie GunawardeneCardioangiologisches Centrum Bethanien, Agaplesion Markus-Krankenhaus, Wilhelm-Epstein-Str. 4, Frankfurt, Germany.ORCID 0000-0001-7561-7185
Alexandra MarxCardioangiologisches Centrum Bethanien, Agaplesion Markus-Krankenhaus, Wilhelm-Epstein-Str. 4, Frankfurt, Germany.ORCID 0000-0002-5908-9463
Julia LurzCardioangiologisches Centrum Bethanien, Agaplesion Markus-Krankenhaus, Wilhelm-Epstein-Str. 4, Frankfurt, Germany.ORCID 0000-0002-3099-8196
Boris SchmidtCardioangiologisches Centrum Bethanien, Agaplesion Markus-Krankenhaus, Wilhelm-Epstein-Str. 4, Frankfurt, Germany.ORCID 0000-0001-5347-9906
Julian ChunCardioangiologisches Centrum Bethanien, Agaplesion Markus-Krankenhaus, Wilhelm-Epstein-Str. 4, Frankfurt, Germany.ORCID 0000-0002-2355-6015
Lukas UrbanekCardioangiologisches Centrum Bethanien, Agaplesion Markus-Krankenhaus, Wilhelm-Epstein-Str. 4, Frankfurt, Germany.ORCID 0000-0002-5234-744X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsPulsed field ablation (PFA) is a non-thermal energy modality for ablation of atrial fibrillation (AF). Although PFA has demonstrated an excellent overall safety profile, increasing evidence suggests an association with intravascular haemolysis, and acute kidney injury (AKI). However, the extent of haemolysis across different PFA catheters remains poorly characterized and warrants further investigation. METHODS AND

resultsWe prospectively enrolled 239 patients undergoing AF ablation using the pentaspline (n = 107), balloon-in-basket (n = 71), or lattice-tip (n = 61) catheter. Laboratory markers of haemolysis, myocardial injury, renal function and haemoglobin were collected pre- and 24h post-procedure. Significant haptoglobin depletion was observed exclusively with pentaspline, [pre 99.8 mg/dL (70.2-122) vs. post 55.7 mg/dL (23.2-91.8); P < 0.001] Reductions with the lattice-tip (P = 0.074) and the balloon-in-basket (P = 0.201) catheter did not reach statistical significance. AKI was only observed with the pentaspline catheter (pentaspline: 4.9%; balloon-in-basket: 0.0%; lattice tip: 0.0%; P = 0.020). Myocardial markers increased across all groups, but significantly higher in pentaspline and balloon-in-basket (P = n.s.) vs. lattice-tip (P < 0.001 vs. pentaspline, P < 0.001 vs. balloon in basket).

conclusionIn this large cohort, contemporary PFA systems appear safe but catheter design influences the extent of haemolysis, AKI, and myocardial injury. The pentaspline catheter was associated with the greatest haemolytic effect and higher transient AKI, without clinically relevant reductions in haemoglobin or persistent renal impairment. Higher levels of myocardial injury in the pentaspline and balloon-in-basket groups correspond to the larger lesion footprints of these devices.

Indexed as

Acute Kidney InjuryAtrial FibrillationCardiac CathetersCatheter AblationHemolysisAgedBiomarkersEquipment DesignFemaleHaptoglobinsHemoglobinsHumansIrreversible Electroporation TherapyMaleMiddle AgedProspective StudiesBiomarkersHaptoglobinsHemoglobinsAtrial FibrillationHaemolysisPulsed Field Ablation

Identifiers

PMID42530033
PMCPMC13439313

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.