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

Background: Evidence regarding the periprocedural safety of laser balloon (LB) catheter ablation for atrial fibrillation (AF) is scarce. Objective: 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. Methods: 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. Results: 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. Conclusion: 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.