Key result
The X3 endoscopic ablation system achieved single-sweep pulmonary vein isolation in 56% of veins and first-pass isolation in 95% of veins, with no acute thromboembolic events.
Why the study?
The novel X3 endoscopic ablation system features a contiguous circumferential ablation RAPID mode, but the feasibility of single-shot fashioned ablation using this device was undetermined.
Does the novel X3 endoscopic ablation system with RAPID mode achieve feasible single-sweep pulmonary vein isolation in patients with atrial fibrillation?
Observational (n=100)
Does the novel X3 endoscopic ablation system with RAPID mode achieve feasible single-sweep pulmonary vein isolation in patients with atrial fibrillation?
The third-generation X3 endoscopic ablation system enables rapid and safe pulmonary vein isolation with high first-pass success rates and short procedure times.
Answers are grounded in this paper and cite their sources.
X3 EAS single-sweep PVI is acutely feasible; leaves open long-term durability and outcomes versus standard PVI.
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-shot fashioned 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 successful PVI with a single RAPID mode energy application, and on "first-pass isolation" defined as successful 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 PVI and first-pass-isolation were achieved in 214 PVs (56%) and in 362 PVs (95%), respectively. Single-sweep PVI rates varied across PVs with higher rates at the superior PVs (61.2% vs. inferior PVs: 49.5%, p = .0239) and at PVs with maximal ostial diameter <24 mm (57.6% vs. >24 mm: 36.8%, p = .0151). The mean total procedure and fluoroscopy times were 43.0 ± 10 and 4.0 ± 2 min, 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-shot fashioned ablation in terms of single-sweep PVI in half or more 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.
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Tohoku et al. (2021) conducted an observational in Atrial fibrillation (n=100). X3 endoscopic ablation system (EAS) with RAPID mode was evaluated on Single-sweep pulmonary vein isolation (PVI) and first-pass isolation. The X3 endoscopic ablation system achieved single-sweep pulmonary vein isolation in 56% of veins and first-pass isolation in 95% of veins, with no acute thromboembolic events.
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