Key result
RF ablation eliminates idiopathic basal cardiac crux VAs in 3 patients by mapping adjacent structures.
Why the study?
Ablation of idiopathic ventricular arrhythmias in the cardiac crux region is challenging due to the complex offset anatomy of the four cardiac chambers.
Case Report (n=3)
Ablation of ventricular arrhythmias originating from the basal cardiac crux region is feasible but requires detailed mapping of adjacent structures including the RV, RA, and LV.
May support ablation feasibility for basal crux VAs via adjacent mapping; hypothesis-generating and should not yet change practice.
Background Ablation of idiopathic ventricular arrhythmias (VAs) in the cardiac crux region is one of the challenging procedures due to the complex anatomical structure where the four chambers of the heart are offset. Although this region is complex, the contiguous cardiac structures allow for the ablation of arrhythmias from adjacent sites. Case presentation We present different anatomical approaches in radiofrequency ablation and the ECG characteristics from a case series of VAs originated from the basal inferior ventricular septum, the corresponding endocardial aspect of the basal cardiac crux region. Conclusions Ablation of VAs originated from the basal cardiac crux region requires detailed mapping in the proximal coronary venous system and the adjacent structures including the RV, RA, and LV. In addition to the characteristic ECG of basal crux VAs, our three cases present an abrupt precordial transition in V2 with R wave amplitude greater than in V1 and V3.
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Khmao et al. (2021) conducted a case report in Idiopathic ventricular arrhythmias (n=3). Radiofrequency ablation was evaluated on Successful elimination of ventricular arrhythmias. Radiofrequency ablation successfully eliminated idiopathic ventricular arrhythmias originating from the basal cardiac crux region in three patients by mapping adjacent structures.
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