Clinical and procedural outcomes of very high-power short-duration vs. standard power ablation for pulmonary vein isolation

Introduction: Pulmonary vein isolation (PVI) using shorter but higher-power radiofrequency (RF) applications can improve lesion quality and reduce procedural time compared to the standard approach, while ensuring similar clinical and safety outcomes. The aim of this study was to compare very high-power short-duration (vHPSD) with standard-power atrial fibrillation (AF) ablation regarding clinical outcomes, procedural efficiency and safety. Methods: All patients who underwent first PVI using RF energy between January 2021 and June 2024 were included. The two groups (standard-power vs. vHPSD AF ablation) were matched using a propensity score analysis and compared at 12 months regarding freedom from AF recurrence, quality of life improvement and safety. Results: < 0.01). AF catheter ablation had a favourable safety profile, with a low prevalence of adverse effects, irrespective of the type of RF energy used. Conclusion: VHPSD AF ablation was a more efficient technique with a shorter procedural time, achieving similar clinical outcomes despite having a lower FPI rate. Both techniques appeared to be safe with low prevalence of adverse effects.