The child, female, 14 years old, hospitalization number: 51257. was admitted for viral myocarditis, II. Atrioventricular block has been admitted for the 3rd time in 20 months, denying a familial history of hereditary disease. She was admitted to the hospital with symptoms of hyperthermia, vomiting and dizziness. The electrocardiogram showed a heart rate of 64 beats/min, junctional escape rhythm, premature supraventricular beats and complete right bundle branch block. There was no obvious shortness of breath, agitation, chest tightness, palpitation, lip cyanosis, clear breath sounds in both lungs, no obvious elevation in the precordial region, enlargement of the heart border to the right, still in rhythm, the first heart sound in the apical region was low and dull, grade II systolic murmur was heard in the left axilla, grade II systolic murmur was heard in the pulmonary valve region, the whole abdomen was soft, not distended, the liver and spleen were not found under the ribs, the limbs were movable, no edema. Chest radiograph showed: no congestion of blood in both lungs, enlarged heart shadow, cardiothoracic ratio 0.68, cardiac ultrasound showed: enlarged left atrium, mild mitral regurgitation, normal left ventricular systolic and diastolic function. The clinical diagnosis was viral myocarditis, atrial quiescence with junctional escape, and complete right bundle branch block, and he was treated with antiviral infection and myocardial nutrition. The intracardiac electrophysiological examination was considered to clarify the diagnosis and to install an artificial pacemaker if necessary. During the operation, the right femoral vein was punctured under local anesthesia, and three electrode catheters were inserted into the right atrium, the bundle of Hirschsprung, and the right ventricle, respectively, for electrophysiological examination. The right ventricular pacing did not show any retrograde conduction from the right ventricle to the right atrium, which led to the conclusion of intracardiac electrophysiological examination: atrial rest, junctional escape rhythm (Hirschsprung’s bundle), and the indication of a permanent pacemaker. The pacing electrode was inserted to the right ventricular apex, and after the optimal pacing position was measured, the skin was incised at 1.5 cm below the midpoint of the left clavicle for 4 cm, the subcutaneous tissue was bluntly separated to create a pacemaker capsule, and the pacemaker was placed inside the capsule. The pacemaker was a Medtronic Sigma 203 with SSR function, pacing threshold: 0.7 mV, R-wave amplitude >7.4 mV, impedance: 503 ohms, frequency: 60 beats/min. After normal debugging, the skin was sutured layer by layer, and the operation was completed with pressure bandaging of the right groin (see the attached figure for changes in the electrocardiogram before and after the operation). After the operation, the ECG monitor showed good pacing response, the child’s heart rate reached 86 beats/min during exercise without abnormal rhythm, and the chest X-ray showed a reduced heart shadow and a cardiothoracic ratio of 0.58. The cardiac ultrasound showed a normal range. He was discharged from the hospital after several days of stabilization and is being followed up. Discussion: Atrial standstill is a very rare arrhythmia, which is a junctional or ventricular rhythm of sinus arrest combined with atrial arrest and not accompanied by retrograde atrial conduction. It can be caused by atrial tachycardia, atrial flutter, atrial fibrillation, sinus block, and sick sinus node syndrome, etc. Atrial stasis and conduction block due to myocarditis often coexist with supraventricular tachycardia and ventricular arrhythmias. In addition to clinical symptoms of vomiting, dizziness and syncope, the diagnosis is based on the junctional rhythm without P, F or f waves on the ECG, small atrial depolarization waves or overlapping P and QRS waves, which should be considered as possible atrial quiescence. This child had viral myocarditis, first II. Atrioventricular block with supraventricular arrhythmias was aggravated by a second viral infection and evolved into atrial stasis, junctional escape rhythm, and complete right bundle branch block. Atrial stasis was clearly diagnosed based on the data recorded above. Straumanis reported a case of atrial stasis in a child treated successfully with methylprednisolone at a dose of 10 mg/kg.d. Sinus rhythm was restored after 3 days. This case of a child with viral myocarditis, II. Atrioventricular block had a good initial treatment and restored sinus rhythm, having had Ⅰ. Atrioventricular block, but this time the heart was severely damaged by reinfection and irreversible damage occurred. After 3 days of methylprednisolone shock therapy, combined with myocardial nutrients, sinus rhythm was never restored and the heart rate gradually slowed down to a minimum of 30 beats/min. Single-chamber pacemakers such as the VVI type (ventricular inhibition pacing), in which both pacing and sensing are in the ventricle, can effectively avoid ventricular bradycardia and ventricular competitive heart rate, and if the frequency response is increased, the VVIR type can increase or decrease the pacing frequency according to physiological needs to a certain extent. Dual-chamber pacemakers such as DDD (atrial all-powerful pacing), which can automatically switch to AAI, VAT, DVI and other pacing modes during operation, are suitable for a wide range of bradyarrhythmias, but are expensive and complicated to install. The indications for pacemaker installation are obvious clinical symptoms, the so-called “symptoms” are symptoms of transient cerebral ischemia due to bradycardia and low cardiac output, such as transient or episodic dizziness, vertigo, dark haze and syncope, of which syncope is the most important symptom, in addition to the following: ① II. and III. Atrioventricular block or sick sinus syndrome with symptoms arising from bradycardia, reduced physical activity or heart failure and poor response to drug therapy. (ii) Slow-fast syndrome, requiring antiarrhythmic drugs. (iii) Complete atrioventricular block with ventricular rate.