Markers of apoptosis and cardiac necrosis during the acute phase of catheter ablation using radiofrequency and pulsed-field energy.

IF 1.9 4区医学 Q3 BIOTECHNOLOGY & APPLIED MICROBIOLOGY

Biomarkers Pub Date : 2025-07-31 DOI:10.1080/1354750X.2025.2536009

Sabri Hassouna, Marek Hozman, Barbora Bacova, Ivana Fiserova, Jana Vesela, Petr Waldauf, Dalibor Herman, Pavel Osmancik

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引用次数: 0

Abstract

Introduction: The mechanism of cell death during pulsed-field ablation (PFA) appears distinct from thermal energy sources like radiofrequency ablation (RFA), with apoptosis often cited as the primary cause in PFA. This study aimed to clarify the mechanism by comparing markers of necrosis and apoptosis after PFA and RFA.

Methods and results: Patients undergoing pulmonary vein isolation (PVI) for atrial fibrillation were randomized to receive either PFA (Farapulse, Boston Scientific) or RFA (CARTO Smart Touch, Biosense Webster). Myocardial necrosis was assessed via troponin I, and apoptosis via soluble cleaved caspase-3 and Fas ligand, measured pre- and one day post-ablation.

Results: Sixty-five patients were enrolled (PFA: n = 33; RFA: n = 32), with comparable baseline characteristics. One day post-procedure, troponin I levels were significantly higher in the PFA group (median 10,102 ng/L; IQR 8,272-14,207) versus the RFA group (1,006 ng/L; IQR 603-1,433). No post-procedure increase in caspase-3 or Fas ligand was observed in the PFA group, and no differences in apoptotic markers were found between groups.

Conclusion: In vivo, apoptosis does not appear to be the predominant mechanism of cardiomyocyte death following PFA for atrial fibrillation.

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使用射频和脉冲场能量进行导管消融急性期细胞凋亡和心肌坏死的标志物。

导读：脉冲场（PFA）消融过程中细胞死亡的机制似乎与使用热能（如射频能量，RFA）的机制有很大不同。在人体体内研究中，细胞凋亡通常被描述为pfa诱导的细胞死亡的主要原因。本研究旨在通过比较PFA和RFA能量消融过程中心肌坏死和凋亡标志物来明确原因。方法和结果：纳入需要肺静脉隔离（PVI）的AF患者，并随机分配使用RFA （CARTO Smart Touch, Biosense Webster）或PFA （Farapulse, Boston-Scientific）能量进行PVI。术前和术后1天检测心肌坏死标志物（肌钙蛋白I）和凋亡标志物（可溶性裂解caspase-3， Fas配体）。结果：65例患者被纳入PFA组（n = 33）和RFA组（n = 32）。两组基线特征相似(年龄60.5±12.7∶64.0±10.7；阵发性心房颤动（60.6% vs. 62.5%）。PFA组1d +的最大肌钙蛋白浓度显著高于PFA组（中位数和四分位数区间），为10102 ng/L；8,272-14,207 vs. 1,006 ng/L；603 - 1433)。PFA后Fas和caspase-3没有增加，PFA和RFA患者术后1d这些凋亡标志物的浓度也没有差异。结论：在急性临床体内环境中，细胞凋亡似乎不是心房颤动脉冲场消融后心肌细胞死亡的主要原因。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Biomarkers 医学-毒理学

CiteScore

5.00

自引率

3.80%

发文量

140

审稿时长

3 months

期刊介绍： The journal Biomarkers brings together all aspects of the rapidly growing field of biomarker research, encompassing their various uses and applications in one essential source. Biomarkers provides a vital forum for the exchange of ideas and concepts in all areas of biomarker research. High quality papers in four main areas are accepted and manuscripts describing novel biomarkers and their subsequent validation are especially encouraged: • Biomarkers of disease • Biomarkers of exposure • Biomarkers of response • Biomarkers of susceptibility Manuscripts can describe biomarkers measured in humans or other animals in vivo or in vitro. Biomarkers will consider publishing negative data from studies of biomarkers of susceptibility in human populations.