Biventricular Impella Support for Ventricular Tachycardia Ablation in a Patient With Severe Dilated Cardiomyopathy

ABSTRACT Ventricular tachycardia (VT) ablation in patients with severely impaired left ventricular (LV) function remains challenging because mapping often requires VT induction or sustained arrhythmia that may not be tolerated. Temporary mechanical circulatory support (tMCS) can improve procedural stability in high‐risk patients. We report a successful VT ablation in a 73‐year‐old man with non‐ischemic dilated cardiomyopathy, severe biventricular failure, and recurrent VT, performed under fully percutaneous biventricular support using Impella CP and Impella RP (Abiomed) via transfemoral access. Hemodynamic stability was achieved only after the addition of right‐sided support. The procedure reduced VT burden without device‐ or access‐related complications.