A novel hybrid technique for the repair of an atrioesophageal fistula post-atrial radiofrequency ablation

An atrioesophageal fistula is an uncommon complication of atrial ablation with a mortality rate of 40-100%. Uniform treatment guidelines have yet to be established. Herein, we illustrate the successful surgical management of an atrioesophageal fistula, avoiding the need for an oesophageal surgical intervention by sealing and clipping of the oesophagus. This novel single-step hybrid approach combining cardiac surgical and gastroenterological techniques provides a less aggressive strategy with potentially a more favourable prognosis. Percutaneous catheter ablation of atrial fibrillation has been associated with atrioesophageal fistula (0.015-0.04%) with a reported mortality rate of 40-100%.