Aims: Prior cardiac surgery limits epicardial ventricular tachycardia (VT) ablation due to epicardial adhesions formation.
Methods and results: We describe an epicardial VT ablation through the coronary venous system in a patient with mechanical mitro-aortic prostheses. The different possible ablation approaches and their potential limitations are discussed.
Conclusion: In selected patients, especially after cardiac surgery, coronary venous system approach can be considered as a safety possible approach for the ablation of some epicardial VTs.