The patient is a 29-year-old male gynecology resident presented with on and off palpitation since last 10 years who is on irregular diltiazem therapy. He is normotensive, euglycemic and with no reversible cardiovascular risk factors. During the course of routine investigation, EKG revealed low atrial rhythm with negative P waves in leads Il, Ill, aVF, and lateral leads with mild dilation of left ventricle with normal ejection fraction. Beta blocker was initiated and the rhythm shortly reverted to normal sinus rhythm and was asymptomatic. Although a benign phenomenon, early evaluation and management of this ectopic rhythm warrants in a young person.