Arrhythmias & electrophysiologyCohort study
Patient vulnerability associated with acute kidney injury after pulsed field ablation: A role for baseline biomarkers and haptoglobin phenotype
- prospective enrolment of consecutive patients
Authors' conclusion
Baseline reduced estimated glomerular filtration rate, low haptoglobin, and elevated LDH were associated with postprocedural AKI, suggesting that patient vulnerability contributes to AKI after PFA.
Study context
- Population
- Patients with atrial fibrillation (AF) who underwent pulsed field ablation (PFA) with a circular-array or pentaspline catheterpatients who underwent PFA
- Participants
- 216 patients
- Exposure
- Acute kidney injury (AKI) group vs non-AKI group
- AKI groupn = 7
Main finding
As reported in the abstract
AKI occurrence
AKI occurred in 7 of 216 patients
7 (3.2%)
Observational data: associations, not effects.
Further findings
| Outcome | AKI group | non-AKI group | P value |
|---|---|---|---|
| Baseline estimated glomerular filtration rate · lower in AKI group | 43.8 [39.2-48.5] mL/min/1.73 m² | 59.7 [49.3-70.3] mL/min/1.73 m² | P = 0.026 |
| Baseline haptoglobin · lower in AKI group | 39.0 [31.5-74.5] mg/dL | 90.0 [57.0-122.0] mg/dL | P = 0.020 |
| Baseline LDH · higher in AKI group | 271.0 [223.0-304.5] IU/L | 186.0 [168.0-209.0] IU/L | P < 0.001 |
Procedural factors and postprocedural changes in hemolysis-related biomarkers
- did not differ between groups
PFA applications
- median applications
- 54 [interquartile range 44-67]
Haptoglobin phenotype
- All AKI events occurred in patients with the haptoglobin 2-2 phenotype
- exploratory finding
Original publication
Patient vulnerability associated with acute kidney injury after pulsed field ablation: A role for baseline biomarkers and haptoglobin phenotype. Heart Rhythm. Published 20 April 2026. doi:10.1016/j.hrthm.2026.04.028
Summarised from the published abstract; every number is checked against it