The man, who had undergone biological aortic valve replacement in 2013, due to severe aortic stenosis, persistent atrial fibrillation and right coronary artery disease was admitted for methicillin sensitive Staphylococcal aureus (MSSA) endocarditis of the aortic valve prosthesis. He was complicated by secondary haemorrhagic stroke and Wernicke's aphasia due to septic embolisation. He was treated with cefazolin and rifampicin. He was admitted with 2 hours of palpitations without chest pain. He was afebrile and examinations revealed tachycardia with heart rate of 240 beats/min. He also had elevated inflammatory markers. An ECG revealed a regular wide QRS complex tachycardia with a right bundle branch block (RBBB) pattern which was identical to a recent ECG with known RBBB. He underwent vagal manoeuvers and received adenosine (6-12-18mg) injection [route not stated]. However, adenosine was ineffective and he showed signs of haemodynamic instability which required synchronised electrical cardioversion, this resulted in asystole and he required advanced cardiac life support.After 2 min of cardiopulmonary resuscitation and epinephrine [adrenaline], spontaneous circulation was resumed and the man was intubated. An ECG showed long PR intervals possibly with 2:1 AVB. Subsequently, his examination revealed pseudoaneurysm. Therefore, he was admitted to the ICU, where he had multiple episodes of the same tachycardia, which required repeated synchronised electrical cardioversion and an increasing use of unspecified vasopressor drugs. Subsequently, he was urgently transferred to the electrophysiology lab. He underwent overdrive pacing and had synchronised shocks, However, the tachycardia almost re-appeared immediately. He started receiving IV amiodarone 300mg, but had no effect. After 17 synchronised shocks, he was in critical situation with haemodynamic collapse. Therefore, emergency catheter ablation was performed. Due to the hypothesis of junctional ectopic tachycardia (JET), the atrioventricular node (AVN) was targeted. The radiofrequency catheter ablation of the AVN interrupted the tachycardia. He had a temporary external pacemaker insertion. The tachycardia recurred after 48 hours at a slower rate, and he underwent redo ablation without induction of the arrhythmia by programmed ventricular pacing or by isoprenaline administration. A permanent pacemaker was inserted after negative blood cultures. At 3 months of follow-up, he had complete AVB, without arrhythmia recurrence. At 2 months, the ejection fraction was 65-70% and he was capable of walking and climbing stairs with assistance.