Multiple coronary artery spasms triggering life-threatening ventricular arrhythmia associated with the radiofrequency ablation of ganglionated plexuses of the left atrium

We report a case of multiple coronary spasms leading to life-threatening ventricular arrhythmia, during left atrium (LA) ablation. Coronary artery spasm is a rare complication during radiofrequency catheter ablation of atrial fibrillation (AF). Previous reports mention that autonomic imbalance leads to coronary artery spasm and ST-segment elevation in the inferior leads, during trans-septal LA catheterization and AF ablation procedures. However, there are few reports detailing the association between ablation sites and changes in the electrocardiogram. We encountered transient ST-segment elevation and refractory ventricular arrhythmia, associated with coronary artery spasm, during radiofrequency ablation of ganglionated plexuses (superior surface of left and right atrium). .