Catheter ablation of left ventricular tachycardia through internal jugular vein: refining the continuous line.

A retrograde approach to the left ventricle (LV) from the femoral artery is most commonly used for left ventricular tachycardia (VT) ablation. However, as the patient population gets older, the prevalence of peripheral vascular disease and aortic valve disease increases, hampering the retrograde access to the LV, which may result in significant technical difficulties. The transseptal approach from the femoral vein is an alternative access to the LV. This approach has been effective for addressing LV VT originating from the posterior and posteroseptal region. However, the transseptal approach from the femoral vein is impossible if there are any obstacles in the inferior vena cava. There are also significant limitations in approaching the basal-lateral region of the LV from this approach. We demonstrated the safety and feasibility of catheter ablation of LV VT via the transseptal approach from the right internal jugular vein.