Which imaging modality is commonly used to evaluate pulmonary vein ostia after AF ablation?

• A. Echocardiography
• B. CT or MRI angiography or Doppler
• C. Nuclear scintigraphy
• D. Plain radiography.

Answer: (B)

After AF ablation, you want imaging that reveals the exact anatomy of the pulmonary vein ostia and any narrowing that could affect flow. CT or MR angiography provides high-resolution, three-dimensional views of the pulmonary veins and their ostia, letting you measure diameter accurately and detect even mild stenosis. Doppler adds functional information by showing flow velocity, which helps determine if a stenosis is hemodynamically significant, but it can be limited by access and visualization of all veins. Echocardiography isn’t reliable for detailed PV ostial anatomy, nuclear scintigraphy only shows perfusion, and plain radiography lacks the necessary detail. So CT or MR angiography, with Doppler as a supplementary flow assessment, is the best approach to evaluate PV ostia after AF ablation.