Atrioesophageal Fistula: A Rare, Life-Threatening Complication of Pulmonary Vein Isolation

Pulmonary vein isolation (PVI) is a common treatment strategy for atrial fibrillation refractory to medical therapy. Atrioesophageal fistula (AEF) is a rare complication of PVI, typically occurring 1 to 6 weeks after ablation, with an incidence between 0.1% and 0.25%.1 Symptoms are often nonspecific and include fever, chest pain, nausea, vomiting, hematemesis, dysphagia, and neurologic deficits.1 We discuss a case of AEF discovered in the context of hospitalization for symptoms of progressive dyspnea, chest pain, and fevers in a patient who underwent PVI 1 month prior.