No, he didn’t bore ED staff with pompous prattle. But this patient did love to hear himself speak.

On uttering a single word, he got atrial premature beats (panel A), according to his ECG, while full sentences set his heart racing (panel B), with sustained atrial tachycardia of up to 167bpm.

The 58-year-old man had been experiencing this talk-induced tachycardia for a month, with intermittent dizziness and palpitations whenever he spoke.