Graphical abstract

A 35‐year‐old man with history of recurrent arrhythmias presented for pulmonary vein isolation. He underwent pre‐procedural screening for thromboembolism risk with transesophageal echocardiogram. He had an incidental finding of a rare fenestrated membrane overlying his left atrial appendage. Additional workup throughout his clinical course revealed genetic mutations in the LMNA and SNTA1 genes. There have been no previous reported genetic mutations reported in cases with LAA membranes.

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