Two Distinct Atrial Breakthroughs During Fast‐Slow Atrioventricular Nodal Reentrant Tachycardia

INTRODUCTION: The slow atrioventricular nodal pathway (SP) typically has a single atrial breakthrough site. METHODS AND RESULTS: We report a case of fast-slow type AVNRT with two distinct atrial breakthrough sites during tachycardia. The earliest atrial activation site (EAAS) was at the right inferior septum, followed by the inferolateral wall of the tricuspid annulus. Ablation at the EAAS shifted it to the inferolateral wall. CONCLUSION: This case demonstrates two distinct atrial breakthrough sites from a single SP in AVNRT.