Conclusions:
A fixed 50W high power short duration circumferential PVI guided by the ablation index and CLOSE protocol reduces the total procedure time and the total RF time compared to standard CLOSE protocol, without increasing the complication rates. Especially the incidence of oesophageal lesions was similar using 50W at the posterior atrial wall, even without oesophageal temperature monitoring. Of note, the oesophageal lesions occurring in the 50W HSDP patients were smaller, more superficial and had a faster healing tendency.