LAUSR

Simple measures such as increasing beta-blocker may take care of a patient’s symptoms. Introduction Tachycardias like atrial fibrillation and ventricular tachycardias are seen in patients who have undergone permanent pacemaker (PPM) implantations; however, supraventricular tachycardias in these patients are very rare. A 20-year-old woman underwent PPM for repeated episodes of syncope owing to complete heart block in 2013. She underwent a dual-chamber PPM implantation and was 100% ventricular paced during regular follow-up. She presented with intermittent episodes of severe palpitations with a narrow QRS tachycardia with a heart rate of 160–180 beats per minute (bpm). Device interrogation showed multiple episodes of tachycardia with simultaneous atrial and ventricular activation during the tachycardia, suggestive of atrioventricular nodal re-entrant tachycardia (AVNRT). An electrophysiology (EP) study was done to study the tachycardia. The narrow QRS tachycardia with simultaneous atrial and ventricular activation in a patient with complete heart block is discussed herewith.