Recurrent and late-onset coronary spasms after cryoballoon ablation procedure in a patient with atrial fibrillation

The feasibility of cryoballoon ablation for treating paroxysmal atrial fibrillation (AF) has been reported. On the other hand, several complications specific to ablation using a cryoballoon may be expected. The prior reports of coronary spasms during procedures describe some mechanisms of coronary spasms; however, those mechanisms remain unknown. We describe a case of recurrent and late-onset coronary spasms after cryoablation procedure that may suggest a possible mechanism not only via the cooling effect on the coronary artery but also via autonomic nervous imbalance by the affected ganglionated plexi located close to the pulmonary veins.