Substrate modification via Epicardial Ablation in a patient with long QT syndrome type II

-Primary electrical diseases may have an underlying substrate that is not visible in conventional imaging such as cardiac MRI but rather in an electrophysiological study displaying abnormal local voltage and signals-Epicardial mapping and consecutive catheter ablation may be a future bailout strategy in patient with long QT syndrome and frequent arrhythmia events refractory to guideline-directed therapy-All conventional therapies and measures such as trigger avoidance and betablockers should be continued after catheter ablation-A careful assessment whether guideline-directed therapies are maxed out and informed consent about new therapies are necessary before offering epicardial ablations to patients with long QT syndrome