PPIH was first described in 2006 M). A systematic review of the literature found 36 reporred cases (5), and the clear association between PPI and hypomagresemia in the community was recently demonstrated in cohort of approximately 95000 patients (6) The majority ofthe 36 cases presented with symptoms of hypomagnesemia, such as seizures, dizziness, nausea, paresthesia, vomiting and diarrhea, muscle cramps, and tetany; some cases also demonstrated cardiac arrhythmia (6). In this case, the patient presented with palpitations. She was subse- quently diagnosed with an atrioventricular nodal teen- trant tachycardia. Her symptoms of palpitations partially resolved after magnesium replacement but were com pletely cured after cardiac ablation therapy. A causal re- larionship berween her hypomagnesernia and cardiac ar- rhythmia remains unclear, although it can be speculated that the hypomagnesemia provided the trigger and un- masked the cardiac conduction defect. Magnesium has complex effects on several cardiac ion channels. Consequently, hypomagnesemia can pre- dispose ventricular ectopic atrial and supraventricular tachyarrhyth including fibrillation, and ventricular tachyarrhythmias (7, 8. With the increasing use of anticoagulation in the man- ement of paroxysmal persistent, and permanent atria