Chaotic or multifocal atrial tachycardia is very rare abnormality in cardiac rhythm for pediatric patients. A newborn female baby was brought to the hospital for tachycardia and showed heart failure symptoms such as poor oral intake, tachypnea, and chest wall retraction. Electrocardiogram and 24-hour holter monitoring revealed chaotic atrial tachycardia and echocardiogram revealed large patent ductus arteriosus and small secundum atrial septal defect associated with pulmonary hypertension. Medical treatment had been unsuccessful and large patent ductus arteriosus was ligated with subsequent improvement of chaotic atrial tachycardia.