What late complication is associated with pulmonary vein isolation that requires surveillance?

• A. Pulmonary vein stenosis
• B. Esophageal injury
• C. Atrial flutter
• D. Pericardial effusion

Answer: (A)

Pulmonary vein isolation creates scar around the vein openings, and over time that scarring can narrow the pulmonary vein ostia. This late narrowing—pulmonary vein stenosis—can progressively reduce blood flow from the lungs and may cause dyspnea, chest symptoms, or recurrent infections, so it warrants surveillance with periodic imaging (CT or MR angiography) after ablation to detect it early and guide treatment if it becomes significant. Esophageal injury and pericardial effusion tend to be acute, occurring around the time of the procedure, while atrial flutter is a rhythm recurrence rather than a structural late complication needing routine imaging surveillance.