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Keywords:

  • atrial flutter ablation;
  • magnetic navigation;
  • heterotaxy

The previously unknown congenital absence of inferior vena cava, an otherwise benign condition, may create difficulties for catheter ablation of arrhythmias. We describe a case of a typical-like atrial flutter, in which magnetic navigation was important for conserving the femoral approach. Electroanatomic mapping with image integration helped define the critical isthmus between the ostia of the suprahepatic veins and the tricuspid valve. (PACE 2012; 35:e312–e315)