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In conclusion, careful interpretation of the ECG can identify the sinus P waves followed by irregular narrow complexes, thus avoiding misdiagnosis and unnecessary treatment. Unifocal HPS tachycardia could present with alternating and gradually changing narrow QRS complexes tachycardia and lead to tachycardia cardiomyopathy. Electrophysiology study and catheter ablation were useful for the diagnosis and treatment of HPS tachycardia but with high risk of atrioventricular block. However, successfully elimination the tachycardia would re