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.