# Double-balloon venous ethanol ablation for treatment of repetitive monomorphic ventricular complexes from intramural infero-basal septum: a case report

## TL;DR

A new method using double-balloon venous ethanol ablation successfully treats hard-to-reach heart arrhythmias.

## Contribution

Double-balloon venous ethanol ablation is presented as a novel and effective treatment for intramural ventricular arrhythmias.

## Key findings

- Double-balloon venous ethanol ablation successfully treated intramural ventricular arrhythmias after RF ablation failed.
- The method is effective even without venous collaterals to the arrhythmic substrate.
- This approach offers a safe alternative for intramural arrhythmia treatment.

## Abstract

Ablation failures are common in case of intramural location of the arrhythmogenic substrate.

We report the case of a patient with cardiomyopathy contributed by frequent monomorphic ventricular arrhythmias (VAs) from intramural basal interventricular septum treated with double-balloon venous ethanol ablation (VEA) after a previous failed endocardial radiofrequency (RF) ablation.

Double-balloon VEA represents a safe and effective therapeutic option in case of intramural VAs also in the absence of venous collaterals joining selectively an intramural arrhythmic substrate.