Background Left atrial appendage (LAA) closure device is an alternative to anticoagulants for stroke prevention in selected atrial fibrillation (AF) patients. The LAA device implantation is safe with short period of learning curve. The standard implantation technique warrants a transesophageal echocardiography (TEE) guided and general anesthesia. In region of Asia Pacific as well as Indonesia, both TEE and general anesthesia are not always available in district hospital. We studied the safety and efficacy of Amplatzer Cardiac Plug (ACP) implantation guided by fluoroscopy only and without general anesthesia. Methods Consecutive nonvalvular AF patients with CHA 2 DS 2 VASc score of ≥2 and HASBLED score of ≥3 are participated. Patients requiring long‐life anticoagulant for any other indication are excluded. The choice of implanted first or second‐generation ACP is that with excess size of 2‐4 mm of measured landing zone diameter. Results Twenty‐five subjects were implanted ACP by means fluoroscopy only (Group A) and 28 subjects using standard technique group (Group B). The median AF duration was 36 months (6‐276 months) and majority of patients (49%) are having permanent AF. The mean CHA2DS2VASc score is 3.9 ± 1.63. Successful implantation of ACPs was 96% in both groups. Nonfatal pericardial effusion occurred in three patients. During 75 weeks of follow‐up period, there were no significant differences of stroke event and death between groups. Conclusion ACP implantation guided with fluoroscopy only is feasible and safe.

Introduction The efficacy of stereotactic body radiation therapy (SBRT) as an alternative treatment for recurrent ventricular tachycardia (VT) is still unclear. This study aimed to report the outcome of SBRT in VT patients with nonischemic cardiomyopathy (NICM). Methods The determination of the target substrate for radiation was based on the combination of CMR results and electroanatomical mapping merged with the real‐time CT scan image. Radiation therapy was performed by Flattening‐filter‐free (Truebeam) system, and afterward, patients were followed up for 13.5 ± 2.8 months. We analyzed the outcome of death, incidence of recurrent VT, ICD shocks, anti‐tachycardia pacing (ATP) sequences, and possible irradiation side‐effects. Results A total of three cases of NICM patients with anteroseptal scar detected by CMR. SBRT was successfully performed in all patients. During the follow‐up, we found that VT recurrences occurred in all patients. In one patient, it happened during a 6‐week blanking period, while the others happened afterward. Re‐hospitalization due to VT only appeared in one patient. Through ICD interrogation, we found that all patients have reduced VT burden and ATP therapies. All of the patients died during the follow‐up period. Radiotherapy‐related adverse events did not occur in all patients. Conclusions SBRT therapy reduces the number of VT burden and ATP sequence therapy in NICM patients with VT, which had a failed previous catheter ablation. However, the efficacy and safety aspects, especially in NICM cases, remained unclear.