The optimal revascularization strategy for emergent left main coronary artery (LMCA) in the setting of acute coronary syndrome (ACS) remains largely an unresolved issue. The most current ACC/AHA 2009 Focused Update Guidelines assign it a IIb recommendation.¹ This carefully adjudicated recommendation stems from the fact that not all LMCA lesions are created equal and outcomes depend among many other considerations on lesion and procedural characteristics, door-to-balloon time, and a myriad of underlying patient comorbidities.

Many clinicians across the world have adopted the transradial approach for coronary angiography and percutaneous coronary intervention (PCI).^1,2 Reduced vascular complications, early ambulation, patient satisfaction, and reduced procedural costs are among the reasons the transradial approach is becoming increasingly popular.^1-6 However, radial artery spasm (RAS) is a common complication of the transradial approach, leading to patient discomfort, procedure failure, and a significant barrier to wide-scale adoption of the technique.^7,8

Atrial fibrillation (AF) is the most prevalent sustained cardiac arrhythmia, increasing in occurrence with age. Based on recent epidemiology, it is estimated to affect 6.1 million Americans, and this number is likely to increase to 15.9 million by 2050.¹ Partly because of the limitations of antiarrhythmic medications, catheter ablation has come into common use for clinical treatment of atrial fibrillation.