Catheter ablation is feasible in patients with both ARVD and Brugada syndrome who have recurrent ICD shocks secondary to refractory VT. Substrate based ablation can be performed in both ARVD and Brugada syndrome without the need to induce unstable ventricular tachycardia in the Electrophysiology lab EP . Epicardial ablation along with endocardial ablation is frequently required in both these entities. In Brugada syndrome sodium channel blocker procainamide flecainide can be used to unmask abnormal areas in some patients. Triggering PVCs if present in the EP lab can be targeted for ablation.