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Key Clinical Message Left atrial posterior wall on the vertebra is often difficult to obtain stable tissue contact with ablation‐catheter. Laser balloon ablation is effective because the compression from the vertebra can be visualized through endoscopy. Abstract When performing pulmonary vein isolation (PVI) with radiofrequency, left atrial posterior wall on the vertebra is often difficult to obtain stable tissue contact with ablation‐catheter because of the movement of the ablation point. Laser balloon ablation is effective for the achievement of durable PVI in cases with such anatomical characteristics because the compression from the vertebra can be visualized through endoscopy.