A 45-year-old lady presented episodes of palpitation for the last 8 years. As routine electrocardiography (ECG) was normal, she was taken up for cardiac electrophysiological study (EPS). During EPS, prior to starting stimulation, she had a typical episode.

Fluoroscopy demonstrated high-frequency bilateral diaphragmatic flutter (DF) lasting for a few minutes, aborted by midazolam. Click here to watch the video: www.annalsofian.org