Ablation of Ventricular Tachycardia Arising from the Great Cardiac Vein - A Rare Cause of Coronary Artery Injury.

We herein report a case of coronary artery injury during epicardial ablation of ventricular tachycardia (VT), and describe an effective method to combat such an injury. A male patient presented with recurrent palpitations which was refractory to medications, with a history of clinically documented VT during the symptomatic episodes. The ablation procedure was performed at the great cardiac vein/anterior interventricular vein (GCV/AIV) junction, in part because pace mapping showed a 12/12 match, and activation map of VT demonstrated the earliest activation site at GCV/AIV junction.