Post by Apostolos Tsimploulis, MD, FACC, FHRS

Complex case of ventricular tachycardia ablation performed in a patient presenting with VT storm and non-ischemic cardiomyopathy. Patient with multiple different induced ventricular tachycardias which were unstable but with areas of interest at the basal lateral wall of the LV and the LV crux area. Electroanatomic mapping was performed endocardially in the left and right ventricle, in the middle cardiac vein using a 2F EPstar catheter and in the epicardial space through epicardial access. Radiofrequency ablation was performed endocardially and epicardially at the above mentioned areas of interest and with the use of ethanol and double balloon technique in the middle cardiac vein. Great result with non inducible VTs in the end of the procedure. Many thanks to Seth Worley whose techniques/tools for cannulating the coronary sinus(middle cardiac vein) from the femoral vein made the workflow significantly easier and of course to the pioneer of ethanol ablation Miguel Valderrabano, MD, PhD. Great support by the mapping team George Vithoulkas and Roger Castelgrande. Pristine job by the electrophysiology fellow Binaya Basyal. #medstarhealth #georgetownuniversity