Despite substantial technical improvements in long-term new generation continuous-flow pumps support, ventricular tachycardia (VT) remains a major complication following left ventricular assist devices (LVADs) implantation. Recent reports that have been through work utilizing a hybrid empirical intraoperative cryoablation to intrinsic scar at the time of VAD placement to reduce postprocedural visual analogic scale. We first time report in Taiwan that combined two procedures ventricular assist device placement and intraoperative open chest epicardial mapping and radiofrequency ablation into a single heart surgery technique at National Taiwan University Hospital. The open chest intraoperative epicardial VT mapping and ablation during the HeartMate 3 LVAD implantation can play a new option for people with serious heart failure and arrhythmia.