Left atrial-esophageal fistula is a highly lethal complication of ablative therapy for atrial
fibrillation. Because of its unusual rate of occurrence, there has not been a uniform approach
to either the diagnosis or corrective therapy. We offer 1 such surgical option based on
presumptive and early diagnosis—left atrial repair with cardiopulmonary bypass followed by
repair of the esophagus with an omental wrap and supported with decompressive
gastrostomy and feeding jejunostomy.

Left atrial-esophageal fistula (LAEF) is a rare complication of radiofrequency ablation (RFA)
procedures undertaken for atrial fibrillation (AF). This complication is associated with
significant morbidity and mortality. Currently, there is no clear consensus on the appropriate
management strategy. We report a case of a LAEF that developed in a patient 2 weeks after
RFA for medication refractory AF. The patient underwent successful repair of the fistula
through a left posterolateral thoracotomy, wherein the esophageal and atrial lesions were …