Radiofrequency ablation of a left anterior accessory pathway in a patient with Wolff–Parkinson–White and major venous drainage anomaly

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.