Ventricular tachycardia following myocardial infarction is often sustained by complex reentrant circuits that are challenging to characterize and treat using conventional electroanatomical mapping. Computational modeling provides a powerful complementary approach to understanding conduction pathway dynamics more effectively and supporting ablation strategies. Here, we present a reproducible and data-driven clinically guided computational framework for the retrospective analysis of post-infarction ventricular tachycardia and ablation procedures. The method integrates patient-specific electroanatomical mapping data-including local activation times, voltage maps, and electrograms-to build a personalized model that captures both structural and functional remodeling via a viability-based scalar field. A novel calibration procedure is introduced to locally estimate tissue conductivity, enabling accurate reproduction of observed activation patterns. The model is used to simulate arrhythmia inducibility and sustainability, and to retrospectively evaluate the impact of clinical radiofrequency ablation, accounting for lesion size and transmurality. In silico exploration of alternative ablation strategies is also performed to minimize lesion volume while maintaining arrhythmia suppression. The entire workflow is designed for rapid execution using a GPU-accelerated monodomain solver and is fully compatible with existing clinical practices, offering a practical tool for substrate interpretation and patient-specific ablation planning.

Management of patients with an implantable cardioverter defibrillator (ICD) and ventricular tachycardia (VT) is a common clinical challenge. Suppression is often warranted. Catheter ablation (CA) is being used increasingly with expanding indications, and novel procedural strategies are being investigated for refractory cases. The purpose of the review is to synthesize the evidence for ventricular tachycardia suppression and the modalities.

Severe abruptio placentae is a major obstetric emergency that may require aggressive resuscitation and central venous catheterization. Femoral venous access is often selected in this context because of its accessibility and absence of pneumothorax risk; however, inadvertent intraperitoneal malposition of the catheter is an exceptionally rare and potentially life-threatening complication. We report the case of a 25-year-old woman at 36 weeks of gestation, admitted for abruptio placentae with intrauterine fetal death and hemorrhagic shock, who underwent emergency cesarean section and was transferred to the intensive care unit (ICU) postoperatively. A right femoral central venous catheter was inserted using the landmark-based technique in a single, apparently uneventful attempt. Postoperative anemia prompted transfusion, but hemoglobin paradoxically failed to improve and continued to decline from 8.2 to 7.8 g/dL despite two units of packed red blood cells, with no identifiable external source of bleeding. Progressive pelvic effusion on serial ultrasound, combined with abdominal distension and tachycardia, prompted surgical re-exploration on postoperative day two. Exploration revealed approximately 600 mL of hemoperitoneum, with the catheter tip identified within the right pelvic peritoneal cavity. The catheter was withdrawn under direct visual control with immediate cessation of bleeding, and the patient recovered fully. This case highlights a rare but serious complication of femoral catheterization, underscores the diagnostic importance of paradoxical hemoglobin kinetics as a signal of occult intraperitoneal hemorrhage, and supports systematic ultrasound guidance and post-insertion catheter verification in obstetric critical care settings.

Vascular Interventional Radiologists (VIRs) frequently care for patients with high severity of illness, multiple comorbidities, and physiologic derangements. The incidence and prevalence of abnormal cardiac rhythms (dysrhythmias) in these patients is high, and these can quickly lead to hemodynamic instability, shock, and death. Therefore, VIRs should be skilled in the evaluation and management of common dysrhythmias. Here, we provide an overview of commonly encountered narrow-complex tachycardias, wide-complex tachycardias, and bradycardias, with emphasis on recognition, diagnosis of underlying etiologies, and initial pharmacologic or electrical treatment steps, with the understanding that advanced treatment and long-term management should be undertaken in conjunction with electrophysiology expertise.

Coronary artery disease is the most common type of heart disease. Revascularization with coronary artery bypass grafting can improve survival in patients with severe coronary artery disease and reduced left ventricular ejection fraction. The Impella 5.5 (Abiomed) with SmartAssist intravascular microaxial blood pump can provide safe and effective perioperative support in patients with severely reduced left ventricular ejection fraction of less than 20%. However, no research has been conducted on Impella 5.5 use with patients who have left ventricular ejection fraction of less than 20% and persistent nonsustaining ventricular tachycardia. More research is needed on the use of the Impella device, specifically regarding patient profile, timing, and device management. This case report describes the outcomes of a 4-vessel coronary artery bypass grafting revascularization procedure assisted by Impella use and dobutamine in combination with antiarrhythmic agents for a patient with both severe coronary disease and persistent nonsustaining ventricular tachycardia postoperatively.