SUMMARYPalpitations are a symptom often reported by patients with apical hypertrophic cardiomyopathy (HCM), yet the arrhythmias associated with this type of HCM have not been studied adequately. Herein, a case of persistently recurrent atrial flutter in a 63-year-old Greek man with apical HCM is presented. Synchronized direct-current shocks were used twice during his hospitalization in order to convert atrial flutter to sinus rhythm. No definite precipitating factor for the induction of atrial flutter was identified.