Anomalies of the venous system may impose serious limitations to the treatment of arrhythmias by means of ablation therapy. We describe a patient who had the Wolff-Parkinson-White syndrome with frequent episodes of antidromic supraventricular tachycardia in whom an ablation was performed. The patient was found to have no inferior vena cava, a hemiazygos vein draining in a persistent left superior vena cava, and a left anterior manifest accessory pathway.
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