Hybrid Epicardial Ventricular Ablation for Arrhythmogenic Right Ventricular Cardiomyopathy

Arrhythmogenic right ventricular cardiomyopathy (ARVC) causes progressive fibro-fatty infiltration of the ventricle (RV) and is associated with arrhythmias (VA). The disease progresses from subepicardium to subendocardium; thus. epicardial ablation improves outcome in patients recurrent VA. When percutaneous unsuccessful, a surgical approach may be required. Limited data are available for minimally invasive hybrid surgical-catheter techniques. Case: A 28-year-old man ARVC presented VA refractory medical therapy following COVID-19 infection underwent endocardial attempted ablation. He had nine or more different inducible morphologies at this study. Epicardial access was unsuccessful due adhesions. Minimally scheduled as multidisciplinary procedure electrophysiology suite. left thoracoscopic provided intrapericardial access. Surgical ports were used facilitate catheter placement mapping. Relevant clinical targeted, substrate modification performed. patient discharged morning. No subjective symptoms implanted-device defibrillation has been required post procedure. Combined catheter-based approaches safe feasible. Multidisciplinary team collaboration key case planning success.