A 38-year-old man with total repair of tetralogy of Fallot at the age of 16 suffered from paroxysmal ventricular tachycardia. His first attack of sustained ventricular tachycardia was recognized at the age of 37 and it was refractory for medical therapy. Electrophysiologic study demonstrated two morphological types of clinical ventricular tachycardias, one originated from the outflow tract of the right ventricle and the other from the area around the patch for closure of ventricular septal defect. He underwent cryosurgical ablation for ventricular tachycardia and patch-closure for residual shunt of ventricular septal defect following the failure of electrical ablation. All of clinical ventricular tachycardias disappeared postoperatively without antiarrhythmic drugs.

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