Distal coronary sinus–left atrial fistulous communication uncovered during atrial fibrillation ablation

This case highlights a rare distal CS-LA fistulous communication involving the LAA and LIPV. It broadens the anatomical spectrum between URCS and partial anomalous pulmonary venous connection. Recognition of these anomalies is critical for procedural safety during AF ablation, underscoring the value of multimodality imaging and intra-procedural venography.