5 COCLUSIONS
The present systematic review and meta-analysis demonstrated that HPSD was a feasible, efficient, safe, and effective approach for AF ablation. The approach had some clear advantages over the LPLD approach, including reduced procedure time, ablation time, and fluoroscopy time. Simultaneously, the HPSD approach was associated with higher first-pass PVI compared with the LPLD approach. Additionally, the HPSD approach could reduce the recurrence of atrial arrhythmias. Moreover, HPSD was as safe as LPLD with low rate of complications. However, there is no consensus about the power and duration settings for HPSD. Therefore, more clinical trials should be conducted to optimize dwell times, power setting, and even catheter selection so as to consistently create perfect lesions in the atrium.