Right atrial position of a return electrode for bipolar ablation of the left posterosuperior process ventricular tachycardia

Introduction Radiofrequency (RF) catheter ablation (RFCA) of ventricular tachycardia (VT) is an effective method of treatment. However, when arrhythmia has ischemic etiology and originates from the posterosuperior process (PSP) of the left ventricular (LV) base, ablation performed with conventional unipolar energy sources may be challenging or impossible. Method and result A 67-year-old male after six unsuccessful RFCA for highly symptomatic VT originating from PSP of LV base underwent successful RFCA using multiple bipolar RF applications delivered between two electrodes located at LV endocardium and adjacent right atrial sites. Conclusion This case report shows that bipolar RFCA can be used for safe and successful treatment of VT originating from deep PSP of LV base.