On August 2, 2011, a male, 23 years old, from a province, went to a local county hospital for symptomatic treatment of chest tightness, epigastric distension, pink frothy sputum, and ventricular tachycardia (ventricular tachycardia) on electrocardiogram, and was discharged with improvement; on August 20, 2011, he went to a local municipal hospital for treatment of “viral myocarditis, pulmonary infection, ventricular tachycardia” due to high fever, chest tightness, cough, abdominal distension, and ventricular tachycardia, and was discharged with improvement. “In May 2012, due to ventricular tachycardia, chest tightness and abdominal distension, which did not improve, he went to a large hospital in a foreign province to optimize the drug treatment, which did not Ablation; May 2012 ~ November 2014, due to ventricular tachycardia, chest tightness, abdominal distension, symptoms are not relieved, travel to the province and the province treatment, optimization of drug therapy, no significant improvement. On November 6, 2014, the patient was hospitalized for ventricular tachycardia, chest tightness and abdominal distension. What is the path to treatment of endless ventricular tachycardia? On admission physical examination, he was clear, poor mental status, cyanotic lips, pulse 120 beats/min, blood pressure 90/64 mmHg, cardiac turbid tone border located 2 cm outside the left midclavicular line at the fifth intercostal space, audible gallop rhythm, Pro-BNP 6,321 ng/L, cardiac ultrasound showed left ventricular end-diastolic internal diameter 69 mm, left ventricular end-systolic internal diameter 59 mm, right atrial diameter 52 mm, right ventricular diameter Cardiac MRI showed a left ventricular ejection fraction of 10.6%. ECG showed ventricular tachycardia. Ambulatory ECG recorded ventricular tachycardia throughout. What should be done in a patient with such a heavy cardiac function with unrelenting ventricular tachycardia? According to the 2014 Expert Consensus on the Treatment of Ventricular Arrhythmias and the 2012 Arrhythmia Device Treatment Guidelines recommendations, catheter ablation should be attempted for restless monomorphic ventricular tachycardia. However, due to poor cardiac function, the procedure is difficult and risky, and many hospitals cannot perform such procedures. Ablation gave him the hope to continue his life After admission, the treatment team discussed and decided to use radiofrequency ablation, but the cardiac function was very poor and the risk of the operation was quite high. What should we do if acute left heart failure, vagal reaction or failure to find the target site occurred during the operation? We prepared carefully for every small part of the surgical procedure. Combined with the characteristics of ventricular tachycardia ECG, it was initially determined that the ventricular tachycardia originated from the right ventricle A. On 2014-11-11, radiofrequency ablation was performed under the guidance of three-dimensional marker measurement, and “sharpening the knife does not miss the woodwork”, sufficient preoperative preparation, also in exchange for a smooth postoperative process. This patient had difficulty crossing the tricuspid annulus with the conventionally used Swartz sheath because of the exceptionally large right atrium and right ventricle, which was immediately replaced with the prepared Agilis adjustable curved sheath, and the right ventriculography was successfully completed. In this way, the ablation catheter, which could not enter the right ventricle, could also enter the right ventricle via the Agilis adjustable curved sheath for 3D modeling of the right ventricle with excitation and drag band labeling. With the preoperative pre-determination of the ventricular tachycardia ECG, the target was quickly found intraoperatively at the right ventricular apex, 32ms ahead, 30W, 43, 10ml/min, 5S ablation, and termination of ventricular tachycardia. At that time, the patient described, “I was so excited that I wanted to cry when I heard Director Zhang say that the operation was successful, but I held back my emotions, thinking of being tortured by the disease in the past few years, I could hardly control my emotions. Pro-BNP decreased to 1323 ng/L 1 week after surgery, and cardiac ultrasound showed significant reduction in each chamber, with left ventricular end-diastolic internal diameter of 68 mm, left ventricular end-systolic internal diameter of 59 mm, right atrial diameter of 38 mm, right ventricular diameter of 42 mm, and left ventricular ejection fraction of 36.4%. At 1 month postoperatively, the patient had good symptoms, and the cardiac ultrasound showed further reduction in each chamber with an end-diastolic left ventricular internal diameter of 60 mm, an end-systolic left ventricular internal diameter of 47 mm, a right atrial diameter of 32 mm, a right ventricular diameter of 23 mm, and a left ventricular ejection fraction of 45.6%. There was no ventricular tachycardia and no premature beats on the ambulatory ECG.