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\begin{document}

\title{Single-Sweep Pulmonary Vein Isolation using the new third-generation
laser balloon -- Evolution in ablation style using endoscopic ablation
system}



\author[1]{Shota Tohoku}%
\author[1]{Stefano Bordignon}%
\author[1]{Luca  Trolese}%
\author[1]{Simone Zanchi}%
\author[1]{Lorenzo Bianchini}%
\author[2]{Felix Operhalski}%
\author[3]{Shaojie Chen}%
\author[1]{KR Julian Chun}%
\author[1]{Boris Schmidt}%
\affil[1]{Cardioangiologisches Centrum Bethanien}%
\affil[2]{Universitätsklinikum Frankfurt}%
\affil[3]{Agaplesion Markus Krankenhaus}%


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  \date{June 17, 2024}


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\begin{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\selectlanguage{ngerman}±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 \textless{}24mm (57.6\% vs. \textgreater{}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.%
\end{abstract}\selectlanguage{ngerman}%



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