High-power short-duration radiofrequency ablation for atrial fibrillation: There is still a country for “old men”

Table 2 Meta-analyses comparing high-power short-duration/very high-power short-duration vs conventional low-power long-duration radiofrequency ablation

Ref.	Study type	Included studies (n)/patients (n)	RCT-only vs mixed	Main efficacy findings	Procedural efficiency	Safety findings	Key limitations
Ravi et al[8]	Systematic review and meta-analysis	13 studies/approximately 2900 patients	Mixed (RCT + observational)	Higher freedom from atrial arrhythmia with HPSD in pooled analysis	Significant reduction in procedure time, RF time, and fluoroscopy	No significant difference in major complications overall	Predominantly observational data; heterogeneous power protocols
Parlavecchio et al[18]	Meta-analysis	6 studies/approximately 1100 patients	Mixed	Trend toward improved arrhythmia-free survival with HPSD	Reduced RF and total procedure duration	Similar rates of major complications, including tamponade and stroke	Limited number of RCTs; protocol heterogeneity
Amin et al[17]	Meta-analysis	8 studies/approximately 1500 patients	RCT-focused (majority randomized)	HPSD noninferior to LPLD for arrhythmia recurrence	Significant reduction in RF time and procedural duration	No significant difference in overall complications or esophageal injury	Limited follow-up duration in some included trials

RCT: Randomized controlled trial; HPSD: High-power short-duration; RF: Radiofrequency; LPLD: Low-power long-duration.