A 63-year-old man with history of paroxysmal atrial fibrillation presented with symptoms of dyspnea and dizziness for several weeks. Curiously, these symptoms occurred only while he was speaking. Electrocardiography revealed paroxysms of atrial tachycardia (AT) triggered by speech, which terminated with cessation of conversation (A, Online Video 1). Vagal maneuvers failed to induce the arrhythmia. Transthoracic echocardiogram and computed tomography of the chest and abdomen revealed no significant cardiac or extracardiac abnormalities. During electrophysiologic study, paroxysms of irregular AT were induced while the patient was speaking (B, asterisks) and electroanatomic mapping localized the site of earliest activation to the roof of the left atrium (LA) (C, arrow). A single ablation lesion at that location terminated the arrhythmia. This is the first description of an arrhythmia triggered by speech. We postulate that this could be due to an anomalous efferent input from the recurrent laryngeal nerve to the left atrial ganglionic plexi. LIPV = left inferior pulmonary vein; LSPV = left superior pulmonary vein; RIPV = right inferior pulmonary vein; RSPV = right superior pulmonary vein.