Right ventricular outflow tract ablation close to an anomalous right coronary artery: When imaging meets electrophysiology

Key Teaching Points•Anomalous coronary arteries are rare and, owing to their unfamiliar course, can significantly increase risk of coronary injury when ablating around the ventricular outflow tracts.•Computerized tomography coronary angiography can be merged with 3D electroanatomical mapping via the CARTO-Segmentation module (Biosense Webster), and this provides important insight into the proximity of coronary arteries to the ablation target. This can be further augmented with intracardiac echocardiography.•This case report shows how CARTO-Segmentation was effective in locating the path of an anomalous coronary artery with excellent spatial resolution during outflow tract ablation, and without the need for invasive coronary angiography. •Anomalous coronary arteries are rare and, owing to their unfamiliar course, can significantly increase risk of coronary injury when ablating around the ventricular outflow tracts.•Computerized tomography coronary angiography can be merged with 3D electroanatomical mapping via the CARTO-Segmentation module (Biosense Webster), and this provides important insight into the proximity of coronary arteries to the ablation target. This can be further augmented with intracardiac echocardiography.•This case report shows how CARTO-Segmentation was effective in locating the path of an anomalous coronary artery with excellent spatial resolution during outflow tract ablation, and without the need for invasive coronary angiography.