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Introduction and Objectives: Ablation of multifocal premature ventricular complexes (PVCs) is challenging. Activation mapping can be performed for the predominant morphology, but may be useless for other less prevalent ones. We aimed to describe the efficacy of an automated pace-mapping software-based ablation strategy for ablating the site of origin of multiple PVC locations. Methods: Consecutive patients referred for ablation of multifocal PVCs were prospectively enrolled. Spontaneous PVC templates were recorded and a detailed pace-mapping map was generated to spot the site of origin of PVCs. Results: A total of 47 PVCs were targeted in 21 patients (five and 16 patients with three or two PVCs morphologies each, respectively). Detailed pace-mapping comprising 73.5±41.6 different pacing locations was performed (best matching 97.2% [IQR 95.9-98.3%] similar to the clinical PVC). Activation points were acquired if possible, although ablation was only based on pace-mapping in 13 (27.6%) foci. Complete acute procedural success was obtained in 14 (66.7%) patients, while one PVC morphology was deliberately not ablated in five patients (23.8%). After 12.3±9.4 months of follow-up, PVC burden decreased from 24.4±10.4% to 5.6±5.0% (p

Congenital anomalies of the inferior vena cava (IVC) are rare and very often diagnosed in asymptomatic patients during computed tomography performed for other purposes. These anomalies can have significant clinical implications, for example if electrophysiology procedures are needed. Diagnostic and ablation procedures are difficult since catheter manipulation and positioning are more complex. We present here a case of successful atrioventricular nodal reentrant tachycardia ablation in a patient with unexpected IVC agenesis, using an azygos route. Resumo: As anomalias congénitas da veia cava inferior são raras e são, muitas vezes, diagnosticadas em pacientes assintomáticos como achados de tomografia computorizada realizada com outros objetivos. Estas anomalias podem ter implicações clínicas importantes, nomeadamente quando estão programados estudos eletrofisiológicos. Os procedimentos de diagnóstico e de ablação são difíceis, uma vez que o manuseamento e posicionamento do cateter é mais complexo. Apresentamos o caso bem-sucedido de uma ablação de taquicardia por reentrada nodal auriculoventricular num doente com agenesia da veia cava inferior, utilizando uma via trans-ázigos. Keywords: Supraventricular tachycardia, Ablation, Inferior vena cava agenesis, Palavras-chave: Taquicardia supraventricular, Ablação, Agenesia de veia cava inferior