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1 Department of Pediatrics, The Johns Hopkins Hospital, Baltimore, and the Department of Medicine, Sinai Hospital of Baltimore
An 11-year-old boy, without evidence of structural cardiac disease, presented refractory passive and active junctional rhythms varying in rate from 60 to 300 per minute associated with atrial parasystole. The clinical course was complicated by heart failure and syncope. The arrhythmias responded poorly be therapy, although the ventricular rate could be adequately controlled with digitalis and propranolol.
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