Pulmonary vein isolation is the mainstay for atrial fibrillation ablation and, since the first introduction in late 90’s, efficacy and safety have significantly increased. The present case based presentation will provide an overview of potential atrial fibrillation ablation complications focusing on methods to avoid or, at least, significantly reduce undesired events. The following learning objectives will emerge:
1) complications rate is low, but unfortunately still not insignificant
2) embolic complications, including silent cerebral events, may be significantly reduced by optimising patient preparation and by performing the procedure under specific conditions
3) esophageus injuries, and other rare but potentially life threatening complications may be abridged and need consideration.