Acute right ventricular failure complicating catheter ablation for right ventricular tachycardia

Introduction Catheter ablation is an important treatmentmodality formanagement of ventricular arrhythmias in the setting of implantable cardioverter-defibrillator (ICD) shocks and ventricular tachycardia (VT) storm. The frequency of patients with nonischemic cardiomyopathy requiring ablation for ventricular arrhythmias is increasing.Arrhythmias of right ventricular (RV) origin are less common than those of left ventricular (LV) origin. Arrhythmogenic RV cardiomyopathy (ARVC), congenital heart disease, idiopathic dilated cardiomyopathy, valvular heart disease, and cardiac sarcoidosis are common causes of structural RV disease that manifest with VT. These diseases often mimic each other; differentiation is important for optimal management of these conditions. RV function is often difficult to define clearly but has major impact on outcomes from VT ablation. Periprocedural mechanical ventricular support is a consideration inVT ablations for patientswith hemodynamic instability. However, most ventricular assist is designed for LV support. We present a casewith predominantlyRV involvement in a presumed ARVC-type cardiomyopathy, where mechanical acute RV failure following ablation culminated in a fatal outcome.