Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a high-risk inherited cardiac channelopathy. In recent years,CPVT complicated by atrial arrhythmias has become a research hotspot. However, CPVT presenting with atrial tachycardia (AT) as the initial manifestation is rarely reported. This article reports a case of a pediatric patient in whom premature ventricular complexes (PVC) and ventricular tachycardia (VT) were only detected more than two years after recurrent syncope, and these ventricular arrhythmias were detected in almost all subsequent re-examinations. Prior to that, only AT was detected on monitoring, without any PVC or VT. A definitive diagnosis of CPVT with AT as the initial manifestation in a child was established. The combination therapy of beta-blockers and propafenone to CPVT was administered. During follow-up, this regimen effectively suppressed PVC, VT and AT simultaneously, and no further syncopal episodes occurred.