Slow pathway ablation without femoral access.

An 80-year-old woman presented with almost daily episodes of tachycardia. She was found to have drug refractory atrioventricular nodal re-entry tachycardia. As she was found to have bilateral common iliac vein occlusion, radiofrequency ablation of the slow pathway was performed via the subclavian vein. This unique experience raises technical issues for catheter positioning.