Dual AV Nodal Non-Reentrant Tachycardia as a Suspected Cause of Tachyarrhythmia-Induced Cardiomyopathy

We describe the case of a 69-year-old female patient who presented with a sensation of her heart pounding and an electrocardiogram showing tachycardia with unusual grouped beating. She was recently diagnosed with heart failure with reduced ejection fraction presumed to be secondary to atrial fibrillation which did not improve with beta-blocker therapy. She underwent an electrophysiology study which demonstrated Dual AV nodal non-reentrant tachycardia status post slow pathway ablation. She had significant improvement in her ejection fraction and palpitations thereafter. This case highlights the significance of correctly identifying the rhythm for management of tachyarrythmia-induced cardiomyopathy.