A 42-year-old gentleman was seen for recurrent paroxysmal palpitations. The palpitations may or may not have been associated with physical exertion, and the duration of the attacks was usually less than a few minutes. The attacks were not associated with chest pain, shortness of breath, or syncope, but mild dizziness may have been noted during the attacks. He has no risk factors for coronary artery disease and the physical examination was unremarkable.