Bipolar ablation combined with VA-ECMO support offers a feasible approach for treating refractory intraseptal ventricular tachycardia in high-risk patients.
Bipolar ablation may succeed in refractory intraseptal VT; hypothesis-generating and requires prospective trials before broader use.
Key Teaching Points•Intraseptal ventricular tachycardia can be difficult to ablate using conventional unipolar ablation methods.•Bipolar ablation can produce successful intraseptal lesions by delivering energy between catheters positioned in the left and right ventricle.•Venoarterial extracorporeal membrane oxygenation can safely provide hemodynamic support in high-risk patients. •Intraseptal ventricular tachycardia can be difficult to ablate using conventional unipolar ablation methods.•Bipolar ablation can produce successful intraseptal lesions by delivering energy between catheters positioned in the left and right ventricle.•Venoarterial extracorporeal membrane oxygenation can safely provide hemodynamic support in high-risk patients.
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Al-Hadithi et al. (2018) studied this question.
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