Purpose of the study  is to highlight mapping system and VT catheter ablation  benefits to improve rates of sudden death through VF/VT in patients with an implantable cardioverter defibrillator (ICD) 
Materials and methods – case presentation - a 65 years old man, admitted into the ED complaining of palpitations and dizziness, having a history of inferior myocardial infarction, with an implantable stent followed by an implantable dual chambre ICD, for recurrent monomorphyc VT.
Actually - a hemodynamically stable pacient, SAP 120mmHg, sinus rhythm, negative troponin level, without biochemical or clinical signs of  actual miocardial ischemia.
Results
Transthotacic echocardiogram - akinetic inferior wall, LVEF of 45%, without further changes compared to the previous examination. Control coronarography - a patent stent.
During interrogation of the ICD 14 shocks were observed in device memory, ineffective with proarrhythmic effect (with degeneration into VF). 
The fluoroscopic image of ICD - the proximal coil at the right atrium level, so device reprogramming was needed and the proximal coil was excluded from the shock configuration. 
An electrophysiological study with PVC has been performed. After a three dimensional mapping system (left ventricle access),  an emergency ablation prcedure was scheduled targeting the areas of fragmented and late potential (cicle lenght of  384ms).
Follow up at 6 months, 1 and 2 years – without episoades of VT/VF or ICD shocks.
Conclusions
VT catheter ablation can reduce the number of ICD interventions, mapping system allowing both activation mapping and substrate mapping during sinus rhythm.
References:
1.	Jackson J Liang. Pasquale Santangeli, David J Callans. Long-term Outcomes of Ventricular Tachycardia Ablation in Different Types of Structural Heart Disease. Arrhythmia & Electrophysiology Review 2015;4(3):177–83
2.	Cimpoesu D, Corlade-Andrei M, Popa TO, Grigorasi G, Bouros C, Rotaru L, Nedelea PL. Am J Ther. Cardiac Arrest in Special Circumstances-Recent Advances in Resuscitation. 2019 Mar/Apr;26(2):e276-e283. doi: 10.1097/MJT.0000000000000927

4 - VT catheter ablation and mapping system may decreases the rate of sudden cardiac death through VF/VT in patients with an implantable cardioverter defibrillator