Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common form of paroxysmal supraventricular tachycardia (SVT). However, it affects only 0.2% of the general population. Due to its rarity, some diagnostic nuances are often overlooked by healthcare providers. This highlights the importance of our case series, which included 62 patients hospitalized at the Cardiac Arrhythmia Unit of Mohamed V Military Hospital in Rabat, Morocco, between January 1, 2018, and December 31, 2022. The study aims to explore the epidemiological, clinical, electrocardiographic, and electrophysiological characteristics of AVNRT. 
 

Our discussion will focus on three key points, all addressing the challenges and misconceptions surrounding AVNRT. We begin by presenting the epidemiological findings of our study. The mean age of the patients was 48.6 ± 13.2 years, with 28.6% of patients experiencing symptom onset after the age of 50. These findings, consistent with similar data from the literature, challenge the common assumption that AVNRT predominantly affects younger individuals. Next, we address the diagnostic challenges of AVNRT, as evidenced by the average diagnostic delay of eight years observed in our case series.   
 

This delay is attributed to factors such as the patients' epidemiological profile, as most had a structurally healthy heart (90.3%), the paroxysmal nature of symptoms, and the normal ECG in sinus rhythm. These factors complicate the differentiation between AVNRT and psychogenic causes, which can present with similar symptoms. We will discuss clinical features that can help identify patients who would benefit most from electrophysiological testing. Finally, we will examine some electrocardiographic aspects of AVNRT, including repolarization abnormalities. These abnormalities, along with chest pain, are commonly reported in SVTs and raise important questions: Could they be indicative of myocardial ischemia? If not, what are the underlying pathophysiological mechanisms? 

Ultimately, our study aims to deepen the understanding of AVNRT and contribute to more accurate diagnostic approaches. 

Selma Siagh is a 7-year-old medical doctor in her third year of cardiology residency currently at at Mohamed V Military Training Hospital in Rabat, Morocco. She completed her medical studies at the Faculty of Medicine and Pharmacy of Rabat, affiliated with Mohamed V University, where she earned her medical degree. She spent two years as an intern, gaining experience in various departments, including intensive care, emergency medicine, and COVID-19 intensive care units. She is now specializing in cardiology, with particular interests in arrhythmology and congenital cardiology.