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Persistent Atrial Standstill in Acute Myocarditis. BACKGROUND: Atrial standstill manifests as absence of any atrial electrical activity in the surface ECG leads. Persistent atrial standstill secondary to acute myocarditis is extremely rare. CASE REPORT: 10-year-old girl had atrial standstill and heart failure due to acute myocarditis. After recovery from myocarditis, heart failure resolved, but the atrial standstill persisted. OUTCOME: Persistent atrial standstill was treated with permanent pacemaker and anticoagulation. MESSAGE: Acute myocarditis may rarely cause atrial standstill that can last even after recovery from myocarditis.