Background: High Power Short Duration (HPSD) ablation has been shown to be feasible for atrial fibrillation (AF) ablation with short procedure times. An alternative method is the use of single shot devices as cryoballoon.

Methods and Results: 76 patients with atrial fibrillation (paroxysmal and persistent) were included in the study. For ablation with High Power Short Duration ablation (n=27) we used a fixed protocol for energy delivery of 50 watts (contact force 3-20 g). Two different mapping systems were used. Cryoballoon (Medtronic, arctic front) was used in 49 Patients. Endpoint of ablation was complete PV entrance and exit block controlled by a at least 10-pole spiral catheter or a high density catheter. Patients in the HPSD group were older on average (65,94 vs. 62,88 years), had a higher BMI (29.89 vs. 28,41) and a higher CHA2DS2-VASc score (2,52 vs. 2,04) than patients in the cryoballoon group. We observed no major complications in both groups. Acute postinterventional pericarditis was higher in the HPSD group. In the follow up there were 8 (16 %) symptomatic recurrences in the cryogroup and 5 (18,52 %) in the HPSD group. Procedure time was significantly longer in the HPSD group.

Conclusions: HPSD and cryoballoon reveal a similar safety and efficacy profile for ablation of atrial fibrillation.