Introduction: SVT is defined as any tachycardia which requires participation of at least one supraventricular structure above the bifurcation of the His bundle (HB) for perpetuation, including the atrial myocardium, the atrioventricular node, the proximal HB, the coronary sinus, the pulmonary veins, the vena cavae, or abnormal atrioventricular connections other than the HB (i.e., bypass tracts)2 Many infants tolerate SVT well. If the tachycardia is sustained for 6 to 12 hours, signs of CHF usually develop Case report: A 34 Week twin 2 born spontaneously conceived out of a non consanguineous marriage to a 27 year G3P2L2 mother with no co morbidities via LSCS was admitted in NICU in view of prematurity and VLBW and respiratory distress Baby cried at birth APGAR at 1 min WAS 6/10 , 5 min 8/10 respectively Baby was intubated and surfactant given in view of grade 2 hyaline membrane disease and was started on inotropic support and antibiotics On day 7 of life patient had multiple episodes of seizures hence was Loaded with iv gardenal Baby was further loaded with iv levipil and epitoin On day 8 of life patient started having consistent heart rate of about 200bpm which did not respond to 3 doses of iv adenosine and thyroid function test were done to rule out hyperthyroidism and sepsis screen was done which turned out to be negative 2D echo was done which was normal On day 11 of life baby was started on Tab propranolol and continued for 6 days which resolved the tachycardia On day 14 MRI BRAIN plain was done which revealed Altered signal intensities appearing hyper intense on T1/T2/FLAIR images with diffusion restriction and low ADC values are seen in the bilateral gangliocapsular region, along corticospinal tracts, mid brain and pons.