Introduction:
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,6ventricular arrhythmias have not been previously localized to the site
of an anomalous coronary artery.
We report for the first time the association of a premature ventricular
contraction (PVC) originating near an anomalous right coronary artery
(RCA), and the successful use of a novel computational mapping algorithm
based solely on a standard 12-lead electrocardiogram (ECG) to guide
concomitant surgical PVC ablation during coronary artery unroofing.