Single-sweep pulmonary vein isolation using the new third-generation laser balloon-Evolution in ablation style using...

Area of Science:

• Cardiology
• Electrophysiology
• Medical Devices

Background:

• The endoscopic ablation system (EAS) is a standard tool for pulmonary vein isolation (PVI) in atrial fibrillation (AF) patients.
• The new X3 EAS introduces a contiguous circumferential ablation mode (RAPID mode) for potentially more efficient PVI.

Purpose of the Study:

• To evaluate the feasibility and effectiveness of single-shot ablation using the novel X3 EAS with its RAPID mode.
• To assess acute procedural outcomes, including single-sweep PVI and first-pass isolation rates.

Main Methods:

• Consecutive patients undergoing AF ablation with the X3 EAS were enrolled.
• Acute procedural data were analyzed, focusing on "Single-sweep PVI" (PVI in one RAPID mode application) and "first-pass isolation" (PVI after initial lesion set).

Main Results:

• In 100 AF patients, 99% of pulmonary veins (PVs) were isolated using X3.
• Single-sweep PVI was achieved in 56% of PVs, and first-pass isolation in 95%.
• Procedure and fluoroscopy times were significantly reduced (43.0 ± 10 min and 4.0 ± 2 min, respectively) with no major adverse events, except one transient phrenic nerve palsy.

Conclusions:

• The X3 EAS with RAPID mode facilitates single-shot PVI in a substantial proportion of PVs.
• This technology improves first-pass isolation rates, shortens procedure times, and demonstrates a favorable safety profile for AF ablation.