Arrhythmias & electrophysiology
Acute kidney injury and haptoglobin depletion after pulsed field ablation: Impact of device type under routine hydration protocol
Authors' conclusion
Under routine perioperative fluid administration, lower renal function and higher body mass index were associated with postoperative AKI, whereas Farapulse use and absence of diabetes mellitus were associated with severe hemolysis.
Study context
- Population
- Consecutive patients undergoing pulsed field ablation (PFA) for atrial fibrillation (AF) with postoperative blood testing of renal function and hemolysis; all received 1500 mL perioperative IV saline
- Participants
- 211 patients
- Exposure
- Farapulse vs PulseSelect PFA systems
- Farapulsen = 117
- PulseSelectn = 94reference
- Outcome
- Risk factors for severe hemolysis (haptoglobin depletion) and AKI after PFA
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Haptoglobin depletion
Odds ratio (95% CI)P value
Farapulse use
3.33(1.56–7.10)
P < 0.01Absence of diabetes mellitus
3.59(1.170–11.100)
P = 0.026- Haptoglobin depletion, all patients
- 56 (27%)
- Acute kidney injury (AKI), all patients
- 13 (6%)
- BMI, AKI vs no AKI (kg/m²)
- 26.5 ± 4.7 vs 23.8 ± 3.7, P = .014
- Baseline eGFR, AKI vs no AKI (mL/min per 1.73 m²)
- 50.9 ± 14.8 vs 63.0 ± 12.6, P < .01
Observational data: associations, not effects.
Further findings
| Outcome | Farapulse | PulseSelect |
|---|---|---|
| Total PFA application number | 56 (range or IQR 44–62) | 43 (range or IQR 39–48) |
Safety
AKI consequences
- Rehospitalized owing to AKI
- 1
- Prolonged stay owing to AKI
- 5
Original publication
Acute kidney injury and haptoglobin depletion after pulsed field ablation: Impact of device type under routine hydration protocol. Heart Rhythm. Published 8 December 2025. doi:10.
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