1. Introduction
Malignant ventricular arrhythmia accounts for 44% of deaths due to left ventricular aneurysm (LVA).1Coronary artery bypass grafting (CABG) combined resection or formation of LVA are the main treatments for LVA, but the postoperative sudden cardiac death caused by malignant ventricular arrhythmia accounted for 29.6% and 36.8% of 30-day and 5-year-death respectively.2In particular, radiofrequency catheter ablation (RFCA) assisted by a three-dimensional electroanatomical mapping (3D EAM) system is used to treat ventricular arrhythmia following the acute myocardial infarction (MI). However, there are still lack of appropriate electrophysiological mapping and transwall RF for resolving ventricular arrhythmia during surgery due to reentry loop and ectopic pacemaker presented in the endocardium, epicardium or myocardial tissue. This report describes the case of a patient with refractory ventricular tachycardia (VT) secondary to LVA, whose treatment with unipolar RFCA was ineffective. We hypothesized that bipolar RFCA assisted by CARTO mapping, one of 3D EAM, would effectively treat refractory VT caused by LVA or scar after MI. Consequently, the patient underwent CABG with bipolar RFCA assisted by CARTO mapping with good postoperative outcomes.