Background:
The efficiency of pulmonary vein isolation (PVI) depends on durability of RF lesions. Recent studies documented sustained continuity of ablation lines, improvements of durability and expected clinical outcomes through altered settings in duration and power. However, the ablation strategy has not been adapted to this new approach and different biophysics of lesion formation. 

Purpose:
The aim of this study was to demonstrate that by adjusting ablation approach to broader geometry of lesions by increasing the minimal spacing between adjacent RF, further significant reduction of procedural time while maintaining sufficient long-term outcomes is achievable.

Methods:
The presented study was a prospective, observational multi-center trial. The periprocedural data were compared with data from a consecutively collected historical cohort.

Results:
In total, 196 patients were included (mean age 62±11 years, male 64.3%). Procedural duration, RF time as well as LA dwelling time were significantly shorter in the HPSD group compared to standard group (73±26 vs. 98±36 min, p<0.001, 14±7 vs. 33±12 min, p<0.001 and 59±21 vs. 77±32 min, p<0.001, respectively). Mean AF-free survival in the first year of follow-up was 304±14 days in the HPSD group versus 340±10 days in the standard group (log‐rank p=0.403). There were no statistically significant differences in the complication rates between the groups.

Conclusion:
Increasing minimal distance between individual application points simplifies AF ablation and further reduces procedure time without negative effect on efficacy and safety. Larger studies are needed to optimally utilize this approach.