Italy were largely unheralded before the start of the tournament, but came out of the traps quickly at the Danube Arena and took a 2-0 lead through an Arianna Garibotti penalty and a Chiara Tabani goal after she showed great strength to hold off a defender.

The US, however, showed why they have won this title on 12 of the last 15 occasions as they pulled level to 2-2 by the end of the first-quarter with goals from Stephanie Haralabidis and Rachel Fattal.

Kiley Neushul put the US ahead for the first time in the second-quarter with a scrappy finish, but the Italians have proved time and again at the Danube Arena that they have attacking firepower and they levelled thanks to Garibotti's second.

Italy led 4-3 at half time thanks to an uncharacteristic error from American goalkeeper Ashleigh Johnson; she was slow coming out to gather a loose ball, allowing Valeria Palmeri to slip her defender, grab the ball and flick it into the corner of the goal.

Stung, US retook the lead in the third-quarter with a double from Makenzie Fischer, either side of a missed penalty from Roberta Bianconi, crashed off Johnson's right hand post.

The two teams - worthy finalists with 100 per cent records from their five opening matches - continued to exchange goals, with US leading 7-6 going into the final quarter.

In the final-quarter Fischer proved to be the star for the US, scoring again to take her individual tally to four from as many shots with a penalty early on to give her side a two-goal cushion, keeping the dauntless Italians at arms length.

With 30 seconds to go, Izabella Chiappini finished off a good team move to make it 10-9, leading to the US calling a timeout as they looked to hang on to their Tokyo 2020 qualfying spot.

This they managed, despite Italy calling their own tactical time out with three seconds to play - they had one more long range shot which flew over, meaning the Super Final title once again belong to America.

Earlier, Russia claimed third place by beating European champions Netherlands 10-7, Ekaterina Prokofyeva the standout with three goals.

Australia earned fifth place by beating hosts Hungary 12-7, while China were consigned to the wooden spoon after losing 13-10 to Canada.