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Introduction - Systemic scleroderma is a rare, progressive, autoimmune disease, with multi organ implications, which may affect the heart, more frequent in the diffuse form (32%) than in a localized one (23%). The ventricular arrhythmias have a negative impact on prognosis and global mortality of the patients with scleroderma. Case report - Female patient, 39 years old, diagnosed with systemic scleroderma, implanted with a cardiac defibrillator (ICD) for sustained ventricular tachycardia (VT), treated by radiofrequency ablation (RFCA), in another center in 2012, was admitted in our center in November 2014, for numerous syncope and ICD therapies (20/4 days), despite Amiodarone treatment. EKG is suggestive for VT with right ventricle (RV), posterolateral region origin. The patient was submitted to an electrophysiological study. A 3D voltage cartography of the RV was done confirming the presence of extended basal fi brosis, with detection of abnormal potentials across the area. Radiofrequency applications were made at the borderline zone in order to isolate slow diastolic scar potentials until non-inducibility of any sustained tachycardia. During the next 40 months the patient remained asymptomatic, with an improved psychological status, without ICD therapies, under 100 mg Amiodarone. Conclusions - Radiofrequency catheter ablation can be an extremely helpful tool in the management of ventricular arrhythmias in patients with systemic scleroderma, at long term, especially in case of electrical storm. The arrhythmia freedom can improve the quality of life and survival, reducing the ICD therapies. [ABSTRACT FROM AUTHOR]