Transverse shifting of the esophagus according to the patient's position helped achieve a safe and successful pulmonary vein isolation procedure.

Although the incidence of causing an atrioesophageal fistula during pulmonary vein isolation is very low, this type of injury results in a very high mortality rate. To prevent this complication, keeping a safe distance from the esophagus to the ablation lesion is a simple but safe method. We report a case in which we were able to shift the position of the esophagus by positioning the patient in a lateral posture in order to keep the esophagus at a safe distance from the pulmonary vein antrum, resulting in performance of a safe and successful pulmonary vein antrum isolation.