3.3 Clinical outcomes
In all included studies, the HPSD approach was found to be associated with a high rate of first-pass PVI (RR: 1.28; 95% CI: 1.12–1.46, P < 0.001 Fig 2A). Additionally, after a mean follow-up of 16 months, the pooled analysis indicated that the HPSD could reduce the recurrence of atrial arrhythmia (OR: 0.70; 95% CI: 0.50–0.98, P = 0.04; Fig 2B). Moreover, the HPSD approach could significantly reduce the total procedural time (WMD: −44.62; 95% CI, −63.00 to −26.23, P < 0.001; Fig. 3A), ablation time (WMD: −21.25; 95% CI: −25.36 to −17.13, P < 0.001; Fig. 3B), and fluoroscopy time (WMD: −4.13; 95% CI: −7.52 to −0.74, P < 0.001; Fig. 3C). Major complications and ETI were similar between two groups (RR: 0.75; 95% CI: 0.44–1.30, P = 0.31; Fig.2C) and (RR: 0.64; 95% CI: 0.17–2.39, P = 0.51 Fig. 2D).