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Single-Sweep Pulmonary Vein Isolation using the new third-generation laser balloon -- Evolution in ablation style using endoscopic ablation system
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  • Shota Tohoku,
  • Stefano Bordignon,
  • Luca Trolese,
  • Simone Zanchi,
  • Lorenzo Bianchini,
  • Felix Operhalski,
  • Shaojie Chen,
  • KR Julian Chun,
  • Boris Schmidt
Shota Tohoku
Cardioangiologisches Centrum Bethanien

Corresponding Author:doctorkyoto@yahoo.co.jp

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Stefano Bordignon
Cardioangiologisches Centrum Bethanien
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Luca Trolese
Cardioangiologisches Centrum Bethanien
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Simone Zanchi
Cardioangiologisches Centrum Bethanien
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Lorenzo Bianchini
Cardioangiologisches Centrum Bethanien
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Felix Operhalski
Universitätsklinikum Frankfurt
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Shaojie Chen
Agaplesion Markus Krankenhaus
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KR Julian Chun
Cardioangiologisches Centrum Bethanien
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Boris Schmidt
Cardioangiologisches Centrum Bethanien
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Abstract

Background: The endoscopic ablation system (EAS) is an established ablation device for pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF). The novel X3 EAS is now equipped with a contiguous circumferential ablation mode (RAPID mode). Aim: To determine the feasibility of single-sweep ablation using X3. Methods: Consecutive patients who underwent AF ablation using X3 were enrolled. We assessed the acute procedural data focusing on “Single-sweep PVI” defined as PVI with a single energy application using RAPID mode to complete the circular lesion set, and on “first-pass isolation” defined as successful visually guided PVI after initial circular lesion set. Results: One-hundred AF patients (56% male, age 68±10 years, 66% paroxysmal AF) were analyzed. A total of 379 of 383 PVs (99%) were isolated with X3. Single-sweep isolation and first-pass-isolation were achieved in 214 PVs (56%) and in 362 PVs (95%), respectively. Single-sweep isolation rates varied across PVs with higher rates at the superior PVs (61.2% vs. inferior PVs:49.5%, P=0.0239) and at PVs with maximal ostial diameter <24mm (57.6% vs. >24mm: 36.8%, P=0.0151). The mean total procedure and fluoroscopy times were 43.0±10 and 4.0±2 mins, respectively. In none of the patients an acute thromboembolic event (stroke or transient ischemic attack) or a pericardial effusion/tamponade occurred. A single transient phrenic nerve palsy was observed. Conclusion: The new X3 EAS allows for single-sweep PVI in 56% of PVs. The new RAPID ablation mode leads to an improved rate of first-pass isolation associated with very short procedure times without compromising safety.
26 May 2021Submitted to Journal of Cardiovascular Electrophysiology
27 May 2021Submission Checks Completed
27 May 2021Assigned to Editor
28 May 2021Reviewer(s) Assigned
21 Jun 2021Review(s) Completed, Editorial Evaluation Pending
28 Jun 2021Editorial Decision: Revise Minor
12 Jul 20211st Revision Received
13 Jul 2021Submission Checks Completed
13 Jul 2021Assigned to Editor
13 Jul 2021Reviewer(s) Assigned
28 Jul 2021Review(s) Completed, Editorial Evaluation Pending
02 Aug 2021Editorial Decision: Revise Minor
25 Aug 20212nd Revision Received
26 Aug 2021Submission Checks Completed
26 Aug 2021Assigned to Editor
26 Aug 2021Reviewer(s) Assigned
08 Sep 2021Review(s) Completed, Editorial Evaluation Pending
08 Sep 2021Editorial Decision: Accept