Key result
Intracoronary adenosine restores TIMI 3 flow in LAD air embolism causing STEMI during AF ablation.
Case Report (n=1)
Coronary air embolism during atrial fibrillation ablation is a rare but life-threatening complication that requires prompt recognition, intracoronary vasodilators, and potentially mechanical circulatory support.
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May aid flow restoration in rare ablation-related air embolism; hypothesis-generating for broader management strategies.
We present the case of a 47‐year‐old woman with persistent atrial fibrillation who underwent catheter ablation. During the procedure, real‐time ST‐segment elevation was observed on surface ECG. An emergency coronary angiography revealed an air embolism in the proximal segment of the left anterior descending (LAD) coronary artery. Intracoronary adenosine was administered, successfully restoring coronary flow (TIMI 3). The procedure was aborted, and the patient was subsequently managed in the coronary care unit due to biventricular cardiogenic shock secondary to myocardial stunning. This case highlights the importance of strict hemodynamic monitoring and prompt recognition and response to uncommon complications during catheter ablation procedures.
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Arteaga-Chan et al. (2026) conducted a case report in ST-Elevation Myocardial Infarction Secondary to Intracoronary Air Embolism (n=1). Intracoronary adenosine was evaluated. Intracoronary adenosine successfully restored coronary flow (TIMI 3) after an intracoronary air embolism caused ST-elevation myocardial infarction during atrial fibrillation ablation.
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