{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T19:08:36Z","timestamp":1783624116486,"version":"3.55.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T00:00:00Z","timestamp":1743379200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005971","name":"German Heart Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005971","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Pulmonary vein isolation (PVI) is a first-line treatment option for paroxysmal atrial fibrillation (PAF). Radiofrequency ablation (RFA) or cryoballoon ablation (CBA) are commonly used modalities. Recent studies demonstrated the superiority and potential benefits of very high-power short-duration (vHPSD) RFA using 70\u2005W compared to conventional RFA (&amp;lt;50\u2005W). Prospective randomized data comparing vHPSD RFA with 70\u2005W with the frequently used CBA in the setting of PAF are lacking.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>We conducted a randomized non-inferiority trial involving 170 patients undergoing de novo PVI for PAF. Patients were randomly assigned in a 1:1 ratio to undergo vHPSD RFA or to receive CBA. The composite primary endpoint consisted of (i) any atrial arrhythmia, (ii) new antiarrhythmic drug (AAD) onset, and (iii) re-ablation during 1 year after index procedure. The non-inferiority margin was predefined as a 10% lower 1-year event-free survival rate in vHPSD compared to CBA (delta = \u22120.1). A total of 170 patients with symptomatic PAF were enrolled and assigned to undergo de novo PVI, with 84 receiving vHPSD and 86 undergoing CBA. The overall study population had a mean age of 65 \u00b1 11 years and included 50.6% women. For vHPSD PVI a 70\u2005W\/7\u2005s anterior and 70\u2005W\/5\u2005s posterior protocol including 3D mapping was used. Cryoballoon ablation was performed as usual. Successful PVI was achieved in all patients. Overall procedure time for vHPSD was significantly longer (81.1 \u00b1 20.0 vs. 67.7 \u00b1 17.2\u2005min; P &amp;lt; 0.001). However, the mere ablation time was comparable (39.3 \u00b1 15.5 vs. 36.7 \u00b1 14.5\u2005min; P = 0.285). Fluoroscopy time and amount of contrast medium were significantly lower for vHPSD PVI (9.2 \u00b1 3.6 vs. 10.5 \u00b1 4.3\u2005min; P = 0.031; 15.5 \u00b1 5.8 vs. 43.1 \u00b1 30.0\u2005mL; P &amp;lt; 0.001). Complication rates were comparable between groups. One pulmonary vein stenosis occurred after vHPSD. Three pericardial effusions and two transient ischaemic attack were reported after CBA. After a median follow-up of 367 days, 73.8% [n = 62, 95% confidence interval (CI): 63.1\u201382.8%] of patients in the vHPSD PVI group and 81.4% (n = 70, 95% CI: 71.6\u201389.0%) in the CBA group remained free of any event. Non-inferiority of vHPSD PVI compared to CBA PVI could not be demonstrated, with a difference of \u22120.076 [95% CI: (\u22120.201 to 0.049)] in event-free survival rates off AADs, as the 95% CI includes the delta of \u22120.1.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In this randomized non-inferiority trial comparing vHPSD RFA to CBA for PVI in patients with PAF, non-inferiority of vHPSD RFA could not be shown. Both methods showed comparable safety outcome with a shorter procedure time for CBA.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euaf066","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T22:18:44Z","timestamp":1743459524000},"source":"Crossref","is-referenced-by-count":7,"title":["HIgh Power short duration radiofrequency ablation or cryoballoon ablation for paroxysmal Atrial Fibrillation (HIPAF trial)"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1807-4860","authenticated-orcid":false,"given":"Arian","family":"Sultan","sequence":"first","affiliation":[{"name":"St. Georg Heart Centre Hamburg, Asklepios Clinic Hamburg , Lohm\u00fchlenstrasse 5, 20099 Hamburg ,","place":["Germany"]},{"name":"Department of Electrophysiology, Heart Centre University Hospital Cologne , Kerpener Strasse 62, Cologne 50937 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7937-5617","authenticated-orcid":false,"given":"Sven","family":"Kreutzer","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart Centre University Hospital Cologne , Kerpener Strasse 62, Cologne 50937 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2213-8946","authenticated-orcid":false,"given":"Jonas","family":"W\u00f6rmann","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart Centre University Hospital Cologne , Kerpener Strasse 62, Cologne 50937 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4667-2200","authenticated-orcid":false,"given":"Jakob","family":"L\u00fcker","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart Centre University Hospital Cologne , Kerpener Strasse 62, Cologne 50937 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9942-0368","authenticated-orcid":false,"given":"Jana","family":"Ackmann","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart Centre University Hospital Cologne , Kerpener Strasse 62, Cologne 50937 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0208-3295","authenticated-orcid":false,"given":"Jan-Hendrik","family":"Schipper","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart Centre University Hospital Cologne , Kerpener Strasse 62, Cologne 50937 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0468-4887","authenticated-orcid":false,"given":"Jan","family":"van den Bruck","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart Centre University Hospital Cologne , Kerpener Strasse 62, Cologne 50937 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2994-2849","authenticated-orcid":false,"given":"Karlo","family":"Filipovic","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart Centre University Hospital Cologne , Kerpener Strasse 62, Cologne 50937 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7054-3535","authenticated-orcid":false,"given":"Cornelia","family":"Scheurlen","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart Centre University Hospital Cologne , Kerpener Strasse 62, Cologne 50937 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