Arrhythmias & electrophysiologyCohort study
Haemolysis and myocardial and neural injury after monopolar pulsed field ablation using a novel lattice-tip catheter to treat atrial fibrillation
- Prospective cohort study
- consecutive patients
Authors' conclusion
Post-procedural haemolysis after PFA for AF treatment is common and occurs across all PFA platforms. Pulsed field ablation using AfferaTM results in more myocardial injury than bipolar PFA systems with no indication of neural damage.
Study context
- Population
- Consecutive patients undergoing pulsed field ablation (PFA) for atrial fibrillation (AF)Affera cohort
- Participants
- 40 patients
- Exposure
- Monopolar lattice-tip PFA vs bipolar single-shot PFA platforms
- Outcome
- Haemolysis and myocardial and neural injury biomarkers (haptoglobin, LDH, bilirubin; hs-troponin T, creatine kinase (CK), creatine kinase MB (CK-MB); S100; creatinine)
- Follow-up
- Pre- and within 24 h post-ablation
Main finding
As reported in the abstract
Δhaptoglobin (PVI-only subgroup) · within 24 h post-ablation
Affera™
(-) 13.8
± 18.5 · mg/dL
PFA-P
(-) 36.8
± 35.9 · mg/dL
PFA-F
(-) 60.7
± 26.3 · mg/dL
P = <0.001
Observational data: associations, not effects.
Further findings
| Outcome | Affera™ | PFA-P | PFA-F |
|---|---|---|---|
| Myocardial injury markers (PVI-only subgroup) | |||
| Δtroponin | 1537 [580] pg/mL | 970 [1023] pg/mL | 1051 [592] pg/mL |
| ΔCK | 232 [168] U/L | 153 [132] U/L | 102 [144] U/L |
| ΔCK-MB | 28.5 [15.3] U/L | 14.6 [12.4] U/L | 13.6 [10.5] U/L |
- Myocardial injury markers (PVI-only subgroup): Δtroponin P = 0.180
- Myocardial injury markers (PVI-only subgroup): ΔCK P = 0.006
- Myocardial injury markers (PVI-only subgroup): ΔCK-MB P = 0.055
S100 (neurocardiac injury) · after ablation
- S100 increased in PFA-P and PFA-F, but not in Affera™
Safety
Haemolysis-related complications
- No haemolysis-related complications
Original publication
Haemolysis and myocardial and neural injury after monopolar pulsed field ablation using a novel lattice-tip catheter to treat atrial fibrillation. Europace. Published 9 September 2025. doi:10.1093/europace/euaf210
Summarised from the published abstract; every number is checked against it