Key result
ECG-guided surgical cryoablation eliminates PVC burden to <1% at 2 years in anomalous RCA.
Why the study?
Ventricular arrhythmias had not been previously localized to the site of an anomalous coronary artery.
Case Report (n=1)
A novel noninvasive 12-lead ECG-based mapping system successfully localized a PVC to the site of an anomalous coronary artery, guiding effective surgical cryoablation and resulting in long-term elimination of PVCs.
Answers are grounded in this paper and cite their sources.
May support mapping-guided ablation near anomalous coronaries; hypothesis-generating and requires prospective validation before practice change.
Anomalous coronary arteries are rare. A malignant course occurs when the anomalous coronary artery takes an interarterial course between the aorta and pulmonary artery (with or without an intramural segment) and is associated with ischemia and an increased risk of sudden cardiac death due to extrinsic compression.1-5 Although the occurrence of ventricular fibrillation (VF) has been reported in patients with malignant anomalous coronary arteries,6 ventricular arrhythmias have not been previously localized to the site of an anomalous coronary artery.
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Jackson et al. (2024) conducted a case report in Premature ventricular contraction and anomalous right coronary artery (n=1). Surgical cryoablation guided by computational ECG mapping was evaluated on PVC burden. Surgical cryoablation guided by a novel computational ECG mapping system successfully reduced PVC burden from 8% to <1% at 2-year follow-up in a patient with an anomalous right coronary artery.
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