Arrhythmias are one of the most common causes of death in the late period post Fontan operation1 and are associated with a 3.5% incidence of ventricular tachycardia (VT).2 The extracardiac Fontan (EC-Fontan) has recently become the most commonly used approach in the Fontan operation. In such patients, catheter ablation (CA) is difficult to perform because the venous access to the heart is limited. A transcaval cardiac puncture (TCP) technique for gaining access to the heart chamber has previously been suggested for EC-Fontan patients.