Radiofrequency ablation is a valuable adjunctive therapy to implantable defibrillators in patients with recurrent monomorphic ventricular tachycardia (VT) after myocardial infarction. Episodes of VT are markedly reduced in most patients, and the major complications are less than 5%. Newer approaches allow successful ablation even when VT is unstable, and when multiple VTs are present. Epicardial mapping and ablation are needed in some patients. Continued advances in technology can be expected to further improve results.