Coronary artery disease is the most common type of heart disease. Revascularization with coronary artery bypass grafting can improve survival in patients with severe coronary artery disease and reduced left ventricular ejection fraction. The Impella 5.5 (Abiomed) with SmartAssist intravascular microaxial blood pump can provide safe and effective perioperative support in patients with severely reduced left ventricular ejection fraction of less than 20%. However, no research has been conducted on Impella 5.5 use with patients who have left ventricular ejection fraction of less than 20% and persistent nonsustaining ventricular tachycardia. More research is needed on the use of the Impella device, specifically regarding patient profile, timing, and device management. This case report describes the outcomes of a 4-vessel coronary artery bypass grafting revascularization procedure assisted by Impella use and dobutamine in combination with antiarrhythmic agents for a patient with both severe coronary disease and persistent nonsustaining ventricular tachycardia postoperatively.