Abstract
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.