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Radiofrequency ablation (RFA) is then mostly performed with low power long duration settings (LPLD), while very high power short duration (vHPSD) may be a valuable alternative. This study aimed to compare procedural parameters, outcomes and complication rates of both approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All consecutive repeat procedures for recurrent AF between 12\/2019 and 03\/2023 were retrospectively analyzed at our center. Only patients with at least one prior ablation were included. RFA was performed using LPLD (\u2264\u200940 W) or vHPSD (\u2265\u200970 W, 7\u00a0s). Ablation strategies were at the operators\u2019 discretion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 340 procedures were included (LPLD: 292; vHPSD: 48). Re-PVI was necessary in the majority of cases (LPLD: 67.8%; vHPSD: 70.8%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.7). Additional ablation lines were performed in 59.9% (LPLD) and 75.0% (vHPSD;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.1). In the vHPSD group more patients underwent substrate modification (CFAE ablation\/scar encirclement; LPLD: 27.7%; vHPSD: 45.8%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.017). Despite this, RF delivery time was shorter with vHPSD (LPLD: 2024\u2009\u00b1\u20091014\u00a0s; vHPSD: 1591\u2009\u00b1\u2009936\u00a0s;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006), while total procedure duration (LPLD: 142.8\u2009\u00b1\u200945.8\u00a0min; vHPSD: 139.2\u2009\u00b1\u200948.2\u00a0min;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.7) and complication rates (LPLD: 5.1%; vHPSD: 8.3%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.3) were similar. After a median follow-up of 361\u00a0days, arrhythmia-free survival was comparable between groups (LPLD: 65.7%; vHPSD: 68.8%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.8).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>vHPSD is an efficient alternative to conventional RFA in repeat procedures for recurrent AF, even in complex cases requiring extended lesion sets.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12872-025-05448-3","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T19:23:39Z","timestamp":1767122619000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Very high power short duration as re-ablation strategy for recurrent atrial fibrillation"],"prefix":"10.1186","volume":"26","author":[{"given":"Jana","family":"Ackmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"W\u00f6rmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"L\u00fcker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Hendrik","family":"Schipper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Hendrik","family":"van den Bruck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelia","family":"Scheurlen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Dittrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friederike","family":"Pavel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodoros","family":"Maximidou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Steven","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arian","family":"Sultan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,30]]},"reference":[{"key":"5448_CR1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euae043","volume":"26","author":"S Tzeis","year":"2024","unstructured":"Tzeis S, Gerstenfeld EP, Kalman J, Saad EB, Sepehri Shamloo A, Andrade JG, et al. 2024 European Heart Rhythm Association\/Heart Rhythm Society\/Asia Pacific Heart Rhythm Society\/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation. 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Circ Arrhythm Electrophysiol. 2022. https:\/\/doi.org\/10.1161\/CIRCEP.121.010663.","journal-title":"Circ Arrhythm Electrophysiol"}],"container-title":["BMC Cardiovascular Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12872-025-05448-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-025-05448-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-025-05448-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T15:59:14Z","timestamp":1781625554000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12872-025-05448-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,30]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["5448"],"URL":"https:\/\/doi.org\/10.1186\/s12872-025-05448-3","relation":{},"ISSN":["1471-2261"],"issn-type":[{"value":"1471-2261","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,30]]},"assertion":[{"value":"12 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 December 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of the University of Cologne (17\u2013440, 14 December 2017). Informed consent was obtained from all patients included in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"J.A. received educational fees from Johnson & Johnson and lecture fees from Abbott and Daiichi Sankyo. J.W. received lecture fees from Abbott and Boston Scientific, and educational fees from Boston Scientific and Johnson & Johnson. J.L. received lecture fees from Johnson & Johnson, Abbott, and Boston Scientific. J.-H.S. received educational fees from Boston Scientific, and lecture fees from Abbott and Daiichi Sankyo. D.S. received lecture fees from Johnson & Johnson, Abbott, and Boston Scientific. A.S. received lecture fees from Medtronic, Boston Scientific, Abbott, and Johnson & Johnson. J.-H.v.d.B. received lecture fees from Johnson & Johnson and Abbott. All other authors declare no conflicts of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"79"}}