Atrioventricular nodal tachycardia occurring during atrial fibrillation

We describe the case of a 32-year-old woman with palpitations and atrial fibrillation (AF) as the only documented arrhythmia. The patient underwent electrophysiologic study and was found to have inducible AV nodal reentrant tachycardia (AVNRT). During a prolonged episode of AVNRT, AF developed in both atria, but AVNRT persisted. Dissociation of the atria during AVNRT is evidence that the atrium is not necessary in AVNRT. This case also illustrates the utility of an electrophysiologic study in locating a potentially curable arrhythmia as the primary cause of AF in young patients.