Abstract
An esophagopericardial fistula developed in a 33-year-old patient after radiofrequency ablation for atrial fibrillation. He was initially managed with an esophageal repair and a left atrial bovine pericardial patch and eventually an esophagectomy. At 6-month follow up he had no symptoms. The case highlights the complexities of managing this life-threatening complication. (Level of Difficulty: Advanced.).