Periprocedural complications after laser balloon ablation procedures for atrial fibrillation: An analysis using a...

Evidence regarding the periprocedural safety of laser balloon (LB) catheter ablation for atrial fibrillation (AF) is scarce.

We aimed to investigate the periprocedural safety of LB ablation for AF compared with that of either radiofrequency or cryoballoon ablation using a nationwide claims database.

Patients who underwent catheter ablation for AF between 2018 and 2022 were identified using the Japanese Registry of All Cardiac and Vascular Diseases - Diagnosis Procedure Combination. The outcomes included in-hospital mortality, emergency 30-day readmission, common periprocedural complications, and a composite of complications. Outcomes were compared between the treatment groups in 2 separate propensity score-matched cohort: LB vs radiofrequency groups and LB vs cryoballoon groups. Mixed-effects logistic regression analysis was performed to calculate the odds ratios for the outcomes.

Overall, 179,207 patients who underwent AF ablation were included. The incidence rate of periprocedural complications after LB ablation was 3.2%, including a 1.6% incidence of stroke. In propensity score-matched cohorts, LB ablation procedures were associated with a higher incidence of periprocedural complications compared with radiofrequency ablation procedures. Furthermore, LB ablation was associated with a higher incidence of stroke or transient ischemic attack than those after cryoballoon or radiofrequency ablation. No significant differences were observed in in-hospital deaths, other complications, or emergency readmissions between LB ablation and either radiofrequency or cryoballoon ablation.

LB ablation was associated with a higher incidence of stroke compared with either cryoballoon or radiofrequency ablation. Most patients experiencing stroke after LB ablation were discharged home.