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001), and fluoroscopy time (WMD -4.13; 95% CI -7.52 to -0.74, P.001). Moreover, major complications and esophageal thermal injury (ETI) were similar between two groups (RR 0.75; 95% CI 0.44-1.30, P=.31) and (RR 0.64; 95% CI 0.17-2.39, P=.51). HPSD was safe and efficient for treating AF with clear advantages of procedural features, it also showed benefits of higher first-pass PVI and reducing recurrence of atrial arrhythmias compared with the LPLD. Moreover, major complications and ETI were similar between two groups. HPSD was safe an