临床与实验心脏病学
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Acute Kidney Injury Subsequent to Hemolysis Following Pulsed-Field Ablation of Atrial Fibrillation

Andrea Natale*, Sanghamitra Mohanty

Based on the findings from prior experimental studies and few recent reports in human patients, hemolysis and subsequent Acute Kidney Injury (AKI) are potential complications of delivery of high-voltage pulses in Pulsed-Field Ablation (PFA). Even though the risk and severity of hemolysis has been demonstrated to be determined by the number of applications, the safety threshold of the same is not clearly delineated yet. However, based on our experience, the risk of AKI can be mitigated by planned peri-procedural hydration therapy and close monitoring of the functional status of the kidneys in the immediate post-procedure period. Large studies are warranted to define the safety limit of the extent of applications and the best therapeutic approach to reduce the risk of AKI to the minimum, when higher number of applications are needed to treat the arrhythmia.