An aorto–left atrial fistula as a fatal complication of radiofrequency ablation for atrial fibrillation: a case report

Aorto–atrial fistulas are extremely rare and potentially fatal complications of cardiac procedures.

An 81-year-old woman with persistent AF underwent radiofrequency ablation with additional anterior wall lesions for extensive low-voltage areas. Seven days later, she was readmitted with non-specific symptoms. Despite initial improvement with pharmacological therapy, she developed sudden haemodynamic collapse. Echocardiography revealed an aorto–left atrial fistula. Intensive treatment was unsuccessful, and the patient died.

This case illustrates a rare, fatal complication of anterior wall ablation for atrial fibrillation. Awareness of this risk is essential, especially in elderly or frail patients requiring extensive ablation.