Introduction: Multiple cardiac ruptures after radiofrequency catheter ablation that requires surgical repair are uncommon. Methods and Results: We describe a 64-year old male patient with paroxysmal atrial fibrillation who had a cardiac tamponade following radiofrequency ablation. Surgical exploration demonstrated two ruptures in the left atrium, one in the right atrium, and one hematoma in the right atrium. MEDLINE, the Cochrane Library, and related databases were searched up to June 2011 without language restrictions, and related literature was reviewed and discussed. The patient has survived from prompt cardiac repair of cardiac ruptures and recovered from surgery without complications. Conclusions: Urgent exploratory surgery with cardiopulmonary bypass is the key to salvage the patient.