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Purpose <p>To compare the extent of intravascular hemolysis, quantified by red blood cell microparticles (RBCµs), between patients undergoing pulsed-field ablation (PFA) for atrial fibrillation (AF) with a variable-loop circular catheter (VLCC) and those treated with a pentaspline catheter (PSC).</p> Methods <p>This prospective, single-center observational study included three cohorts of patients undergoing first-time AF ablation: (1) pulmonary vein isolation (PVI) by the PSC (PSC PVI), (2) PVI plus posterior wall and/or mitral isthmus by the PSC (PSC PVI+), and (3) PVI plus posterior wall by the VLCC (VLCC PVI+). Blood samples were collected at baseline, immediately post-ablation, and 24&#xa0;h after the procedure to measure RBCµs and other biochemical markers.</p> Results <p>The study included 77 patients (64.2 ± 9.5 years, 42.9% female): 22, 25 and 30 in the PSC PVI, PSC PVI+, and VLCC PVI + groups, respectively. All groups exhibited a significant transient rise in RBCµs concentration immediately after ablation (<i>p</i> &lt; 0.001), returning to baseline within 24&#xa0;h. Peak RBCµs levels were highest in the PSC PVI + group, followed by PSC PVI and VLCC PVI+ (all pairwise comparisons <i>p</i> &lt; 0.001). The total number of applications was highest in the PSC PVI + group and lowest in the VLCC PVI + group, correlating with the magnitude of hemolysis.</p> Conclusions <p>In patients with persistent AF, the level of intravascular hemolysis after PVI combined with posterior wall ablation using the VLCC catheter was associated with lower intravascular hemolysis compared to the PS catheter used in both paroxysmal and persistent AF cases.</p> Graphical Abstract <p></p>

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Variable-loop circular vs. Pentaspline catheter: hemolysis outcomes in pulsed-field ablation procedures for atrial fibrillation

  • 期刊论文

  • 发表日期：

    2026年2月19日

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  • Marek Hozman,
  • Pavel Osmančík,
  • Barbora Bačová,
  • Jakub Karch,
  • Jana Veselá,
  • Věra Filipcová,
  • Lukáš Povišer,
  • Jana Hozmanová,
  • Sabri Hassouna,
  • Josef Hornof,
  • Dalibor Heřman

摘要

Purpose

To compare the extent of intravascular hemolysis, quantified by red blood cell microparticles (RBCµs), between patients undergoing pulsed-field ablation (PFA) for atrial fibrillation (AF) with a variable-loop circular catheter (VLCC) and those treated with a pentaspline catheter (PSC).

Methods

This prospective, single-center observational study included three cohorts of patients undergoing first-time AF ablation: (1) pulmonary vein isolation (PVI) by the PSC (PSC PVI), (2) PVI plus posterior wall and/or mitral isthmus by the PSC (PSC PVI+), and (3) PVI plus posterior wall by the VLCC (VLCC PVI+). Blood samples were collected at baseline, immediately post-ablation, and 24 h after the procedure to measure RBCµs and other biochemical markers.

Results

The study included 77 patients (64.2 ± 9.5 years, 42.9% female): 22, 25 and 30 in the PSC PVI, PSC PVI+, and VLCC PVI + groups, respectively. All groups exhibited a significant transient rise in RBCµs concentration immediately after ablation (p < 0.001), returning to baseline within 24 h. Peak RBCµs levels were highest in the PSC PVI + group, followed by PSC PVI and VLCC PVI+ (all pairwise comparisons p < 0.001). The total number of applications was highest in the PSC PVI + group and lowest in the VLCC PVI + group, correlating with the magnitude of hemolysis.

Conclusions

In patients with persistent AF, the level of intravascular hemolysis after PVI combined with posterior wall ablation using the VLCC catheter was associated with lower intravascular hemolysis compared to the PS catheter used in both paroxysmal and persistent AF cases.

Graphical Abstract