Steinbeck G, et al. - As retrospective studies, registries, and controlled trials assessing the risks of catheter ablation for atrial fibrillation and flutter might underestimate “real world” conditions, researchers investigated complications in a nationwide approach, including all cases undergoing catheter ablation for atrial fibrillation and atrial flutter in Germany in 2014. They analyzed a total of 33,353 in-hospital cases, identified using ICD-10-GM-based German Diagnosis Related Group codes and the well-differentiated German Operation and Procedure Classification. Compared to previous reports, this study revealed higher overall and major complication rates. Although few patients were treated in low volume centers, they were exposed to a higher overall complication risk. They observed high rates of life-threatening complications in association with atrial flutter ablations. Advanced age combined with highly prevalent cardiac, pulmonary and, vascular comorbidities seemed to play an important role.