Hemolysis-related acute kidney injury after pulsed field ablation: An emerging concern in patients with hematologic disorders

The case report by Sawada and colleagues1 illuminates a critical intersection between emerging ablation technology and hematologic vulnerability, documenting hemolysis-induced acute kidney injury (AKI) following pulsed field ablation (PFA) in a patient with Waldenström's macroglobulinemia (WM). This confluence of factors, including an innovative ablation modality, an underlying paraproteinemia, and pharmacologic endothelial modification, creates a convergence of risk factors for renal complications that demands our attention as PFA rapidly enters mainstream clinical practice.