A case report described direct angiographic visualization of coronary air embolism after atrial fibrillation catheter ablation, with a suspected atrioesophageal fistula as the underlying cause. The event is notable because it is rare but potentially fatal, and the report emphasizes how visualization during angiography can clarify mechanism. The report adds to the safety literature around AF ablation complications by documenting a fatal-pathway scenario and reinforcing the need for rapid recognition and escalation when symptoms emerge post-procedure. For electrophysiology programs, the case supports improvements in monitoring protocols and informs clinical risk awareness for atrioesophageal injury. While single-patient evidence cannot define incidence, it can sharpen diagnostic suspicion and emergency management frameworks across centers performing high-volume ablations.