The first 50 VT ablations: A fellow’s guide to the learning curve

My first ventricular tachycardia (VT) ablation procedure lasted 9 hours. I was a cardiology fellow in Ireland, watching what seemed like controlled chaos—entrainment mapping, activation mapping, and substrate modification. I understood little, but I knew I wanted to master this discipline. That case eventually brought me to Boston to train at the Brigham, where volume, mentorship, and complexity promised immersion in VT ablation.