Arrhythmias & electrophysiology
Renal safety of high-dose pulsed field ablation of atrial fibrillation: A prospective real-world analysis
Authors' conclusion
The safety margin for the number of PFA applications seems to be higher in real-world practice; delivering 70-100 PFA applications via a pentaspline catheter during AF ablation remains a relatively low risk of AKI.
Study context
- Population
- Patients treated with pulsed field ablation (PFA) for atrial fibrillation (AF)consecutive patients treated with PFA for AF
- Participants
- 115 patients
- Exposure
- Acute kidney injury (AKI) vs non-AKI groups; correlation of hemolysis and AKI with number of PFA applications
- AKIn = 8
- Outcome
- AKI
- Follow-up
- 24 hours after the procedure
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Patients who developed AKI
8 patients
7%
Clinically significant renal dysfunction
1 case
Observational data: associations, not effects.
Further findings
| Outcome | AKI | non-AKI | P value |
|---|---|---|---|
| PFA applicationsNo statistical difference | 88.25 ± 35.37 | 70.12 ± 16.94 | P = 0.5 |
Change in serum creatinine (SCr) across 4 subgroups based on PFA applications in quartiles · 24 hours after the procedure
- Comparable across quartile subgroups
- P = 0.1
Increase in SCr per pulse
- Clinically relevant increase in SCr per pulse, only with more than 38 PFA applications
- 0.004 mg/dL
- Pulses required to produce 0.3 mg/dL increase in SCr
- ≈140
Original publication
Renal safety of high-dose pulsed field ablation of atrial fibrillation: A prospective real-world analysis. Heart Rhythm. Published 22 July 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →