1 Introduction:
Catheter ablation for atrial fibrillation (AF) is recommended as an effective therapy, reducing the risk of stroke, heart failure and mortality to improve the quality of life1. As the cornerstone of AF catheter 2,3, pulmonary vein isolation (PVI) aims to produce continuous, transmural and durable lesions around the pulmonary vein. And remarkably, pulmonary vein reconnection (PVR) can be a key driver of AF recurrence4,5. High-power short-duration (HPSD) ablation strategy comprises the use of higher RF power (≥40W) and shorter duration (5-15s) of each RF energy application, and HPSD applications result in larger lesion diameters and smaller lesion depths compared to conventional (20–35W, 10-30s) applications 6. Recent studies 7-9 demonstrate that HPSD is safe and efficient for treating AF, reducing radiofrequency catheter ablation (RFA) and procedure times, without increasing major complication rates. Meta-analyses or randomized controlled studies comparing atrial arrhythmia recurrence and rates of PVR between HPSD and conventional RFA settings with or without the guidance of ablation Index (AI) or lesion size index (LSI) are lacking. Therefore, this meta-analysis aims to compare the effectiveness and safety of HPSD and LPLD settings in RFA for AF 10.