Significant hemolysis is present during irreversible electroporation of cardiomyocytes in vitro

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Authors

FISEROVA Ivana FISER Ondrej NOVAK Marek TRNKA Jan GIBALOVA Antonia KVAPIL David BACOVA Barbora HOZMAN Marek HERMAN Dalibor BENEŠOVÁ Klára OSMANCIK Pavel

Year of publication 2025
Type Article in Periodical
Magazine / Source Heart Rhythm
MU Faculty or unit

Faculty of Medicine

Citation
web https://www.sciencedirect.com/science/article/pii/S1547527124031382?pes=vor&utm_source=clarivate&getft_integrator=clarivate
Doi https://doi.org/10.1016/j.hrthm.2024.08.019
Keywords Atrial fibrillation; Cardiomyocytes; Hemolysis; Irreversible electroporation; Pulsed field ablation
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Description BACKGROUND Pulsed field ablation (PFA) of atrial fibrillation is a new method in clinical practice. Despite a favorable safety profile of PFA in atrial fibrillation ablation, rare cases of renal failure, probably due to hemolysis, have recently been reported. OBJECTIVE The aim of this study was to determine the rate of hemolysis and cardiac cell death during in vitro PFA with different electric field intensities. METHODS Blood samples from healthy volunteers and mouse HL-1 cardiomyocyte cell lines were subjected to in vitro irreversible electroporation using 216 bipolar pulses, each lasting 2 mu s with intervals of 5 mu s, repeated 20 times at a frequency of 1 Hz. These pulses varied from 500 V to 1500 V. Cell-free hemoglobin levels were assessed spectrophotometrically, and red blood cell microparticles were evaluated by flow cytometry. Cardiomyocyte death was quantified with propidium iodide. RESULTS Pulsed field energy (1000 V/cm, 1250 V/cm, and 1500 V/cm) was associated with a significant increase in cell-free hemoglobin (0.32 +/- 0.16 g/L, 2.2 +/- 0.96 g/L, and 5.7 +/- 0.39 g/L; P < .01) and similar increase in the concentration of red blood cell microparticles. Significant rates of cardiomyocyte death were observed at electric field strengths of 750 V/cm, 1000 V/cm, 1250 V/cm, and 1500 V/cm (26.5% +/- 5.9%, 44.3% +/- 6.2%, 55.5% +/- 6.9%, and 74.5% +/- 17.8% of cardiomyocytes; P < .01). CONCLUSION The most effective induction of cell death in vitro was observed at 1500 V/cm. This intensity was also associated with a significant degree of hemolysis.
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