Venous Ethanol for Ventricular Tachycardia

Eligibility Criteria

• * Male and female, ages of 18 and 85 years and with a prior ICD implant
• * Diagnosed with ischemic cardiomyopathy: Prior myocardial infarction (pathological Q waves or imaging evidence of regional myocardial akinesis/thinning in the absence of a non-ischemic cause)
• * One of the following VT events (within last 6 months): a) ≥3 episodes of VT treated with anti-tachycardia pacing (ATP) or anti-arrhythmic drugs; b) ≥1 appropriate ICD shocks; c) ≥3 VT episodes within 24 hr; d) sustained VT below detection rate of the ICD documented by EKG/cardiac monitor
• * Patients deemed candidates for RF ablation of VT
• * Able and willing to comply with pre-, post-, and follow-up requirements
• * Willing to sign the informed consent
• * Serum creatinine \>1.5 mg/dL, or creatinine clearance \<30 ml/min
• * Left ventricular (LV) ejection fraction ≤10%
• * Mobile LV thrombus on echocardiography
• * Absence of vascular access to the LV
• * Disease process likely to limit survival to \<12 months
• * New York Heart Association class IV heart failure
• * Cardiac surgery within the past 2 months (unless VT was incessant),
• * Acute coronary syndrome in the past 2 months (acute thrombus diagnosed by coronary angiography, or dynamic ST segment changes demonstrated on EKG)
• * Another reversible cause of VT (e.g. electrolyte abnormalities, drug-induced arrhythmia)
• * Severe aortic stenosis or mitral regurgitation with a flail leaflet
• * Pregnancy
• * Unwilling or unable to provide informed consent
• * Covid-19 positive testing within 14 days of randomization procedure
• * Enrolled, or planning to get enrolled, in another research study during his/her participation on the Velvet trial